REGIONAL — Hundreds of advanced practice providers at Essentia Health ended their strike Tuesday and returned to work without securing any of the workplace changes they sought, as Essentia continues to refuse negotiations while pursuing a legal challenge that has stalled.
The striking nurse practitioners, physician assistants, nurse midwives, and clinical nurse specialists from 69 facilities across northeastern Minnesota and Wisconsin walked off the job, protesting Essentia’s refusal to bargain since they voted to unionize nearly a year ago. That includes providers who work at Essentia clinics in Ely and Virginia.
The providers are returning to work with no resolution to the fundamental dispute that sparked their organizing drive: their demand for a voice in workplace decisions affecting patient care in rural communities.
The core of the dispute centers on Essentia’s appeal to the National Labor Relations Board challenging the scope of the proposed bargaining unit, which would include advanced practice providers, or APPs, across the health system’s vast rural network. Essentia argues the unit is too large and contradicts federal rules typically separating hospital and clinic staff.
The appeal has been stalled because the NLRB lacks enough members for a quorum under the current administration. While two individuals were nominated for NLRB membership Tuesday, they must still be confirmed by the U.S. Senate.
The Minnesota Nurses Association, which represents the union being appealed, maintains that Essentia’s legal challenge doesn’t exempt the health system from bargaining with a legally certified union.
The strike highlighted divisions within Essentia’s APP workforce. While more than 400 providers participated in the work stoppage, nearly 60 percent of the health system’s advanced practice providers continued working, according to Essentia.
Christie Erickson, a nurse practitioner and part-time administrator who remained on the job, said she sympathized with some striking colleagues but felt her priority was maintaining patient relationships.
“For me, it’s really about the fact that I’ve got trusting relationships with patients that I’ve been seeing for years, decades, even,” Erickson said in an interview during the strike. “As a nurse practitioner, that relationship that I have with patients is something that I feel is kind of sacred.”
Erickson, who would be excluded from the union due to her management role, said she believed some striking APPs weren’t getting “the complete story” from union leadership.
Essentia temporarily suspended services at three clinics and one urgent care facility in the Brainerd Lakes area while redistributing appointments to larger facilities with more staff.
The health system emphasized that APPs handle 44 percent of clinic visits and 88 percent of urgent care visits across its network, underscoring their importance to rural health care delivery.
“We have been able to continue to provide patient care at all of our sites,” Erickson said.
The APP strike was part of a larger labor dispute at Essentia that also included a two-week strike by clinic nurses and health care workers, which ended Tuesday. Unlike the APPs, the clinic nurses secured some movement from Essentia, including an agreement to combine four separate nursing groups into one negotiating unit.
The coordinated strikes marked the first time in Minnesota history that clinic nurses, health care workers, and APPs united in collective action, according to the union.
As providers return to work, the fundamental issues that led to the strike remain unresolved. The legal challenge could take months or longer to resolve, potentially leaving the APPs in limbo while serving communities that depend on their care.
Kelly Higgins, an advanced practice provider for Essentia, said the strike succeeded in bringing attention to rural health care challenges even without immediate workplace changes.
“This wasn’t just a strike in Duluth,” Higgins said. “Rural providers, small-town clinics — we all showed up. We made sure people saw the real story: care in our communities is on the line, and we’re ready to fight for it.”
The providers have not withdrawn their unfair labor practice charges against Essentia, which remains active as the providers return to their patients with what they describe as “renewed determination” to secure a voice in workplace decisions affecting rural health care.