Essentia clinicians join nurses on strike in northern Minnesota

At least 200 nurse practitioners, physician assistants and other clinicians went on strike Thursday against Essentia Health, which is refusing to acknowledge their status as unionized members of the Minnesota Nurses Association.

The unusual walkout involves clinicians providing primary and urgent care at 70 Essentia locations across Minnesota, participating in surgeries and rounding on patients in hospitals. Essentia leaders responded by rescheduling some patient visits to different clinics, moving some surgeries from outpatient sites to hospitals and temporarily closing four small-town clinics that are staffed by one provider per day.

“We are doing everything we can to ensure the patients are getting the care that they need in the time that they need it,” said Christie Erickson, director of the nurse practitioners and physician assistants in Essentia’s northeast Minnesota region.

The stalemate is different from the one that prompted about 300 nurses from Essentia clinics to go on strike earlier this week after negotiations failed to reach a first contract. Essentia hasn’t even started negotiations with the clinicians, who voted in November 2023 to seek union representation.

The lack of recognition frustrated union members such as Jenna Coldwell, an Essentia physician assistant who serves as a hospitalist. Providers are getting stretched by longer hours and higher patient loads, she said during a news conference from a strike site in Virginia, Minn. She accused Essentia leaders of responding with “shrugs and empty promises” that have prompted some colleagues to leave.

“Our resilience and ability to continue to provide high-quality care for our patients is threatened because we are exhausted to the point of neglecting ourselves and our families,” she said.

The union was initially accepted by the National Labor Relations Board, but Essentia has appealed that decision, arguing that the group of roughly 400 clinicians is too diffuse in their geography and specialties to be part of the same bargaining unit. The group also includes nurse midwives and clinical nurse specialists.

The clinicians provide roughly half of the care to patients in Essentia’s northeast region clinics, which range from International Falls to Hinckley, and 90% of Essentia’s urgent care. Vicki Brady, a Duluth nurse practitioner, accused Essentia of forcing the practitioners into the walkout and argued that the health system should be less concerned about challenging the union and more concerned about the burnout and problems among its clinicians.

“We are not on the strike line because Essentia has not met our demands,” she said. “We are on the strike line because Essentia is unwilling to even ask what our demands are.”

Erickson said only half of the unionized clinicians went on strike, which reduced the disruption to patient schedules. Essentia didn’t hire temporary replacements, which is more complicated when it involves the credentialing and licensing of clinicians besides nurses. A nurse practitioner for more than two decades, Erickson said she already provides patient care two days a week and would be increasing that amount to cover gaps.

The strike comes amid heightened union activity in Minnesota’s health care sector. Clinic doctors with Minneapolis-based Allina Health also voted to unionize two years ago, and recently held a picket and voted to strike if negotiations don’t produce a contract. A group of inpatient doctors at Allina’s Mercy Hospital in Coon Rapids also unionized and has yet to reach a contract.

Strikes by as many as 15,000 hospital nurses in the Twin Cities and Duluth areas were averted this week after hospitals and MNA negotiators reached tentative agreements, which were in part motivated by budget cuts by Congress and the Donald Trump administration that could reduce public funding to hospitals. Nurses are voting this week to ratify those agreements on new three-year contracts.