Nurses at two HCA hospitals in Central Florida approve new union contract

After a contentious round of union contract negotiations, registered nurses at two HCA hospitals in Central Florida — HCA Lake Monroe in Sanford and HCA Osceola Hospital in Kissimmee — have voted to approve new contracts negotiated between their union and their multibillion-dollar employer, HCA Healthcare.

According to the union, National Nurses United, the new three-year collective bargaining agreements deliver an average 15 percent wage increase for registered nurses — the largest guaranteed wage increase ever secured for nurses at both facilities, over the life of the contract — plus improvements to nurses’ “floating” policy and the option of adding personal pronouns and preferred names to name badges. Under the new floating policy, RNs can only be temporarily assigned to other units with specialties similar to their normal unit, in an effort to increase safety.

Importantly, with safe staffing levels emerging as a key issue during contract negotiations, their new contracts also include a commitment by HCA to launch a short-term pilot program that will designate dedicated break relief staff for nurses.

The program doesn’t require HCA to hire more staff, but it will help to ensure there is a nurse that can help relieve a co-worker who needs to take a water break, bathroom break or meal break during their 12-hour shift without risking the health and safety of patients they’re assigned to.

Nurses at hospitals owned by HCA — one of the country’s largest for-profit operators of healthcare facilities — have for years raised alarms over chronic understaffing in their facilities, which nonetheless reap HCA billions of dollars in revenue per year. This year, as union-represented nurses at 17 HCA hospitals in Florida and five other states faced contract expirations, safe staffing levels once again secured the spotlight as a key concern for the 8,500 nurses involved in contract talks.

“In the six years that I’ve worked here, I’ve just seen essentially deterioration in the staffing, and in the supplies and the equipment,” Nathan Knight, a registered nurse at HCA Lake Monroe, told Orlando Weekly earlier this year. “That makes me worried, and made me decide that we needed to step up and fight harder.”

Understaffing hospital units can have dangerous and even deadly consequences, and HCA, headquartered in Nashville, is no stranger to such complaints. While the for-profit operator has a recent history of spending hundreds of thousands of dollars on “union avoidance” services to counter new organizing drives or decertify existing unions, nurses and other HCA hospital staff have for years warned of a “care crisis” driven by their employer’s allegedly willful decision to understaff their facilities in order to decrease labor costs.

Nurses have framed this decision as a danger not only to their own health and well-being — citing problems such as burnout, moral injury and stress — but a danger to their patients as well, whom they cannot attend as closely if their caseloads are too high.

Marissa Lee, a nurse at HCA Osceola Hospital, for her part celebrated the new contracts in Central Florida, delivering modest gains on the staff burnout front. “This is huge news for our hospitals,” said Lee, a registered nurse in the labor and delivery unit at HCA Osceola Hospital, in a statement. “We’ve been bargaining for most of this year, so getting a deal done is big, especially when we got some major wins on safe staffing.”

National Nurses United represents about 350 nurses at HCA Lake Monroe and more than 650 nurses at HCA Florida Osceola. Nurses at both hospitals first voted to unionize in 2010, representing some of the union’s earliest victories in a state where only about 6 percent of the workforce has union representation. Their previous three-year contracts with HCA expired on May 31, 2024, but were extended while negotiations continued.

According to the union, the pilot break relief program for RNs is a win the union secured in all HCA contracts they have negotiated so far this year, including the contracts covering Lake Monroe and Osceola Hospitals, as well as contracts covering eight other HCA facilities on Florida’s Gulf Coast, where communities are still recovering from back-to-back Hurricanes Helene and Milton.

“Hurricane Milton underscored how important it is to have strong, safe hospitals in our communities,” said Collette Salomon-Belfond, a registered nurse at HCA Florida Fawcett Hospital in Port Charlotte, in a statement. “These new contracts are going to make working conditions at our hospitals better, and that means better conditions for our patients.”

HCA Healthcare, based in Nashville, Tennessee, owns more than 180 hospitals and 2,400 sites of care in 20 states plus the United Kingdom. A significant number of these hospitals are based in Florida and in Texas, where nurses unionized with NNU have also secured new contracts this year.

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This article appears in Oct 16-22, 2024.