“What led us to strike is the same thing that led us to unionize: patient safety,” says Beth Redwine, a “mother-baby” nurse who works in the maternity ward at St. Mary Medical Center in Bucks County, Pennsylvania.

Redwine is one of nearly eight hundred nurses who went on strike Tuesday in response to what she and her coworkers described as foot-dragging by Trinity Health, which bought St. Mary in 2015, during what has been a nearly yearlong contract negotiation.

Livonia, Michigan–based Trinity owns over ninety hospitals nationwide. As for St. Mary, nurses describe it as a profitable institution. The Philadelphia Inquirer reports that the hospital “made an average of $58 million in annual profit in the last three years,” according to Trinity financial documents, making it one of the region’s most profitable hospitals. They say that their problems began not with the pandemic, but when Trinity took over the hospital.

“We’ve had inadequate staffing since Trinity took over, and we tried to negotiate with them prior to unionizing, but they weren’t having any of it,” says Donna Halpern, a cardiac critical care nurse who has been at St. Mary for fifteen years. The nurses voted to unionize with the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), which represents 8,500 nurses and health care professionals across Pennsylvania, in August 2019.

Safe staffing is the key point of disagreement in the ongoing contract negotiations. Safe staffing ratios delineate how many patients a nurse is expected to care for at one time. Given that nurses are tasked with monitoring patients’ health on a constant basis, catching each and every tell of a possible downturn, short staffing is particularly dangerous. In the context of a pandemic of an illness that remains volatile and little understood, it can be deadly.

Nurses at St. Mary say that while an intensive care unit (ICU) nurse should have one or two patients at the most, at their hospital now, nurses often have three. As for some of the designated COVID-19 units, Redwine describes them as “perpetually short-staffed.”

Related to the issue of staffing ratios is a more familiar demand: wages. At St. Mary, nurses say pay isn’t competitive with other nearby hospitals, which pay $6 to $7 more per hour, and that this has led to a loss of nearly 250 nurses over the past two years, creating the staffing crisis.

During a marathon negotiation last week that began at 9 AM Thursday morning and ended at 3:30 AM Friday, Trinity offered what nurses describe as a 5 percent raise for the first year of the contract, but say that this was according to a tiered scale, meaning that not all nurses would receive the raise. They say they were presented with the proposal around 2 AM and given thirty minutes to consider the offer. They rejected it.

In discussing the strike, nurses acknowledge the high stakes of such a workplace action at a hospital during the pandemic, but say that it is precisely these stakes that led them to strike.

“We aren’t abandoning our patients at this time. We’re out here for them,” says Redwine. She notes that rather than being angered by the action, the community has been honking in support and bringing food and drinks to the picket line. It’s a continuation of a relationship built at the start of the pandemic: back then, facing a shortage of personal protective equipment (PPE), St. Mary nurses appealed to the public for equipment, and in response, community members gave them twenty thousand pieces of PPE, including N95 masks and gloves.

The strike was planned to last Tuesday and Wednesday. In response, Trinity brought in agency nurses to staff the hospital. Beginning Thursday morning, the hospital locked out the striking nurses until the expiration of the replacement nurses’ contract. This means St. Mary nurses won’t be returning to the hospital until Sunday.

“I’m so damn proud of all of them,” says Bill Engle of his fellow nurses who have braved the cold to hold the strike line this week. “We don’t know how this is going to turn out in the end, but taking a leap of faith, showing our solidarity, we’re believing in one another. We’re taking a stand, but when you start messing with nurses’ ability to care for our patients, that’s our line in the sand.”