Registered nurses at Ascension Seton Medical Center (ASMCA) in Austin, Texas voted overwhelmingly in favor of ratifying a three-year contract Monday, announced the National Nurses Organizing Committee/National Nurses United (NNOC/NNU). This is the first-ever union contract at ASCMA, which is the largest private-sector hospital in Texas to form a nurses union.

Capping a campaign that began during the Covid-19 pandemic – including a historic election vote in September 2022 and historic strikes in June and December 2023 – registered nurses are celebrating winning key demands on patient safety and nurse retention.

“We are so proud of this contract that sets enforceable standards for safe staffing, which has always been our number one priority,” said Zetta Hackleman, RN in the perioperative services unit. “This contract holds Ascension accountable to enforcing safe nurse-to-patient ratios, which we know saves patient lives and boosts nurse recruitment and retention. It also gives us a formal process through the professional practice committee to regularly advocate on behalf of our patients and our communities.”

The contract covers over 1,100 registered nurses, including nursing residents and fellows, who Ascension management had initially refused to include in the contract. The contract goes into effect immediately and will expire March 2027.

“Nurses fought for our community and our community fought with us, and we are so grateful for the overwhelming support we received, including from our patients and allies in the labor movement,” said Kris Fuentes, RN in the neonatal intensive care unit (NICU). “We hope our victory inspires nurses all over Texas and the South to organize unions in their facilities. Together, as union nurses, we can protect our patients and our profession.”

Highlights of the contract, which will improve patient care and boost nurse recruitment and retention, include: 

• Staffing improvements: Staffing grids in contract, including a minimum ratio of one RN for every two patients (1:2) in the intensive care unit and neonatal intensive care unit, one RN for every two patients (1:2) in the labor and delivery unit, one RN for every four patients (1:4) in the emergency department; process to settle staffing disputes.
• Professional Practice Committee: Monthly meetings with 10 RNs and management to address solutions for ongoing patient care concerns.
• Patient and RN protections: Standard-setting language on health, safety, and infectious disease prevention and workplace violence prevention.
• Fair and transparent wage scale based on years of experience: An average of over 11 percent compensation increase, with some receiving as much as a 25.9 percent increase, over the life of the agreement.

NNOC nurses at three other Ascension facilities – Ascension via Christi St. Joseph and Ascension via Christi St. Francis in Wichita, Kan. and Ascension St. Agnes in Baltimore, Md. – are also in negotiations for their first union contracts.

NNOC nurses have also been raising the alarm on Ascension’s alarming closures of labor and delivery units nationwide, in contradiction to the Catholic nonprofit’s mission to serve “the poor and vulnerable.” The report, “Dangerous Descent: How Ascension Betrays its Mission by Gutting Care for Pregnant Patients and Babies”, found the hospital system cut 26 percent of its labor and delivery units within the last decade. These closures were more likely to take place in areas with higher rates of low-income, Black, and Latine patients, who are already at greater risk of pregnancy- and childbirth-related complications and death. This trend has particularly impacted families in Austin and surrounding Travis County.

National Nurses Organizing Committee is an affiliate of National Nurses United, the largest and fastest-growing union and professional association of registered nurses in the United States with nearly 225,000 members nationwide. NNU affiliates also include California Nurses Association, DC Nurses Association, Michigan Nurses Association, Minnesota Nurses Association, and New York State Nurses Association.