Worcester, Mass.—On May Day outside of St. Vincent Hospital here, there was a sing-along going on. It was the 55th day that the nurses, members of the Massachusetts Nurses Association, had been on strike at the hospital, and the sunny weather and blooming flowers meant morale was high.

Supporters, from local City Council member Khrystian King to the Worcester branch of the Democratic Socialists of America, as well as members of other unions like the Teamsters and IATSE, joined the nurses to celebrate the worker’s holiday and to demand that the hospital, as the thematically rewritten lyrics to one song went, “bring in more nurses to care in there!”

“Patient safety in that building has been lacking for some time now,” explained nurse and vice president of MNA Marie Ritacco. “We have been at the negotiating table with the hospital for about two years, and once the pandemic hit, of course we had to take a pause and take care of business inside.” They hadn’t thought that conditions could get worse, but during the pandemic, they did, and the nurses made the difficult choice to take a strike vote. “I think [Tenet] thought that we were so broken down that we weren’t going to continue fighting for what we know is safe and appropriate,” Ritacco said.

The St. Vincent nurses strike may be the longest nursing strike in the country for nearly 30 years; nursing strikes typically last only a few days or weeks. They’re also striking against a massive for-profit company—Dallas-based Tenet Healthcare Corporation—which owns St. Vincent, and which the nurses say puts profits over patient care. But around the country, the pandemic has pushed nurses and hospital workers, already squeezed by a patchwork health care system and private ownership, into a position where many of them feel that they have no choice but to use the strike weapon to demand change to the way health care is provided.

The MNA set up its strike headquarters in a former bank around the corner from St. Vincent, and it was bustling with nurses and supporters in blue and red strike gear at all times of day. A long table overflowed with much-used wearable strike signs—“ON STRIKE for safe patient care,” as well as several health care inside jokes like “Don’t lie, we can spot A-Fib” and “no more bare-bones staffing” and of course the ubiquitous “Healthcare Not Profits”—just inside the door, across from a table laden with snacks. Further down the hall there’s a room filled with toys for picketers’ kids to play with.

The week before the May Day festivities, Marlena Pellegrino and two of her colleagues were walking the line, back and forth in front of one of the hospital’s multiple entrances, keeping an eye out for CEO Carolyn Jackson to pass them on her way home from work. It was cold and windy but Pellegrino and the others wore MNA blue knit hats and matching masks; Pellegrino’s red coat and her red fleece-lined boots also matched.

Everyone calls Pellegrino “Mother Marlena,” an MNA staffer told The Nation, because she’s been there since the nurses at St Vincent first unionized 20 years ago—the issue then was staffing levels, too. She’s cochair of the bargaining unit, and she exudes warmth even when she talks about the things that make her angry. “Our patients were suffering. We’re the experts at the bedside. We don’t lie. We haven’t given up our livelihood and our health insurance and time with our family and part of our emotional health for the last seven weeks just because.”

Tenet received almost $3 billion from the federal government in stimulus money and other funding, and yet it actually furloughed staff during the crisis. And the nurses, Ritacco said, “had to fight for the appropriate personal protective equipment. They held it under lock and key. They said that they had sufficient N95s, but it became very clear that they did not.” The union wound up spending thousands of dollars finding PPE for the nurses. And yet, Ritacco said, “on the very day [we took our strike vote] they announced that they had made over $414 million in profit in the previous year.”

The hospital’s ownership might be far away, but the people of Worcester still feel connected to the hospital, which has been in operation since 1893 before being acquired by Tenet in the 1990s. It operates now, wrote Amy Littlefield in The New Republic, as a kind of “zombie” Catholic hospital, wrapped in the trappings of its past as a religious community institution and using those trappings to justify exploitation of workers. But the nurses still believe in the work they do. “It’s a community hospital,” said Pellegrino, who attended the nursing school that used to be attached to St. Vincent. “We have always had a very high standard of care.… to be a nurse at St. Vincent Hospital—it’s not just a job.”

Public officials from city councillors to Senators Elizabeth Warren and Edward Markey have visited the picket line, and Warren, Markey, and Representative Jim McGovern also sent a letter to Tenet’s CEO urging Tenet to negotiate over staffing. Local parent and Clark University professor Cara Berg Powers told the crowd on May Day that her daughter was born at St. Vincent but that she and her family canceled appointments at the hospital for as long as the nurses were on strike. Honking horns from passing cars punctuated her points. A member of the Massachusetts Teachers Association, Berg Powers spoke of the way that teachers and nurses are expected to provide their work for the love of helping, of caring, and never make demands for themselves. But the demands the nurses were making, she said, were “what all of us here in this city deserve.”

Open-ended health care strikes like the strike in Worcester are rare. Only a handful of large nursing strikes in the past 30 years have lasted more than a month, with a 56-day strike by Oregon nurses among the longest in recent memory. But despite their rarity, nurses felt it was important to send a message. “We felt it was that important to have an open-ended strike to send them a very serious message that they need to change things,” said Pellegrino. “What’s going on in that hospital with those patients is not right.”

Even though open-ended nursing strikes are rare, nurses in Worcester aren’t alone—they’re part of a wave of activity by organized and unorganized nurses. Of the eight major strikes in 2020, half involved nurses, including 7,800 nurses who struck against Swedish Medical Centers in Washington in January—the largest strike that year. Even more large strikes were averted with last-minute deals after unions took strike votes and even issued strike deadlines, including a narrowly averted strike across Providence hospitals in Washington potentially involving 15,000 nurses and health care workers.

There’s even more happening below the surface. Important strikes like the one at St. Vincent often go unnoticed, in part because the Bureau of Labor Statistics tracks only strikes involving 1,000 or more workers. That misses a lot of what’s happening, making invisible the fights of many care workers deemed essential throughout the pandemic. Even though the BLS tracked only four nursing strikes in 2020, nurses struck at Santa Rosa Memorial Hospital, Riverside Community Hospital, Montefiore New Rochelle, Backus Hospital, St. Mary’s Medical Center, Albany Medical Center, and AMITA St. Joseph Medical Center—all strikes involving hundreds of nurses.

Pandemic concerns and frustrations are continuing for nurses across the country, playing a role in their decision to turn to strikes. On April 28, 4,000 health care workers at Allina Health in Minnesota announced a May 10 strike deadline, telling KARE 11 that workers had “given so much over the past year to keep our patients and communities safe during COVID.” Likewise, 93 percent of the 725 nurses at Kapiolani Medical Center for Women & Children in Honolulu voted in January to authorize a strike, telling the Honolulu Star-Advertiser that there was a “high level of frustration among the nurses” and that the hospital continued to force nurses to reuse N95 masks and intermingle with Covid-19 and non-Covid-19 patients on single shifts.

For her part, Ritacco isn’t accepting this as the new normal. “I think nurses around the country realize that as we had to lessen standards during the pandemic to survive that, that a lot of hospitals are getting the idea that maybe they can get away with that for the long-term, and it is not going to be possible.”

A surge in organizing activity by nurses suggests Ritacco is right. Two thousand nurses voted to unionize at Mission Hospital in Asheville, N.C., in September of 2020, giving unions a rare victory in the South. Another 2,000 nurses voted to unionize at Maine Medical Center in late April. These victories—and other elections at hospitals over the past year—indicate nurses are turning to unions to address workplace issues in hospitals stressed by an unprecedented pandemic.

“People need to start demanding,” Ritacco said. “This is for the good of our communities, and we deserve this. This is our money from the CARES Act and the Recovery Act getting filtered into these institutions, and we need to demand better. And so taking on the fight is definitely a labor of love.”

Back at St. Vincent, the nurses got what they considered their first credible offer from the hospital on that same May Day, and headed back into bargaining with a counter-offer Wednesday, April 5, their 59th day on strike. After a long day of negotiations, the union reports, “there are still significant differences on the issue of staffing that still need to be resolved,” and so as of this writing, the strike continues.

Morale, the nurses told The Nation, was good. They’d finally had their unemployment benefits approved, and they were ready to stay out as long as it took. “Being on this picket line for us, it’s where you come to find your peace and your inspiration to go on,” Pellegrino said. “You’re home, but all of a sudden you’re in your car driving to the picket line. It’s a line of honor and you walk it with pride. I’ve never been prouder to be a nurse or to stand with any of my 750 coworkers.”