Perspective from a nurse at Astria Toppenish

Astria Toppenish nurses fought for better wages but faced devastation as the hospital closed the Family Medical Center. Efforts continue to restore OB/GYN services for the community.

This story was published in the Spring-Summer 2023 issue of The Washington Nurse.

This story appears in In the Frame: Toppenish.

Astria Toppenish registered nurses were able to negotiate a contract that gave them between 20-34% raises last summer. Since we were some of the lowest paid hospital nurses for years, this contract adjusted our wages so that we were finally able to retain and recruit nurses to our rural hospital. Within the past few years, we had lost about 30 of our 80 nurses due to higher wages at other hospitals, as well as unsafe staffing and burnout. With the new contract negotiated by WSNA, we were also able to add steps (wage steps by years worked), add float pay, and increase shift differentials. Important increases were obtained to increase BSN/MSN, certification, preceptor, and charge pay.

Unfortunately, on the heels of this outstanding contract, Astria dealt a blow to the entire Toppenish community, as well as some of our nurses right before Christmas. Without any warning to staff or the community, we were informed that the Family Medical Center at the hospital was closing.

Now women will have to go at least 30 minutes to receive care. That could be the difference between life and death for many.”

We have a large population of women that live in poverty and have high-risk pregnancies and this hospital, and our Family Medical Center provided medical care for many underserved populations. No attempts were made by Astria to problem solve or reach out for a solution. The hospital said the department was losing money.

After the closure announcement, the Toppenish City Council held two town meetings with very high attendance. Many nurses, physicians, community members, and women shared stories of how the Family Medical Center nurses had saved lives, delivered generations of babies, and lifted the community through the excellent care given. One thing that had made this department so beloved was the individualized care; this included many cultural beliefs and practices that had been incorporated into the outstanding patient care given. Even the Toppenish mayor shared her story of experiencing a life-threatening ectopic pregnancy. Her physician told her that had she not been able to make it to Toppenish Family Medical Center, she would have died.

Now women will have to go at least 30 minutes to receive care. That could be the difference between life and death for many. There is now an investigation of the unit closure by the state Department of Health. When Astria bought Toppenish hospital in 2017, there was a Certificate of Need that stated that Astria agreed to provide OB/GYN and pediatric care for 10 years. They have violated that agreement by closing as they did. There has also been an excellent response, led by the nurses, WSNA, physicians, and other affected parties, to begin to work toward a public hospital district. Twice the number of signatures than were needed were obtained to begin the process. The county commissioners have now approved that petition to be moved forward to be on the ballot, pending the workgroup getting the appropriate number of signatures needed.

All of us nurses know that there have been closures of OB departments across the nation. We also know that these closures are profit-driven. Along with our nurses, WSNA, and the community, we will continue to do whatever it takes to try to get the OB/GYN services back to our Toppenish patients.

Julia Barcott is a registered nurse working in the Intensive Care Unit at Astria Toppenish. Barcott is also part of the WSNA bargaining team at the hospital, chair of WSNA’s Cabinet on Economic and General Welfare, and a member of WSNA’s Board of Directors.