Cascade Behavioral Health Hospital employees returned to work this week after spending more than three months on strike, demanding more workplace safety following a chaotic evening over the summer that left 11 workers injured.
Staff at the 137-bed Tukwila psychiatric hospital officially ratified a new three-year contract on Wednesday, in which Cascade management promised to hire a designated security team, implement safer staffing-to-patient ratios, add workload protections and increase wages, among other things. The agreement covers 220 Cascade nurses, mental health technicians and service workers, who this week called the contract a “big win.”
“I’m very proud,” said Meseret Amare, who’s worked at Cascade as a mental health technician since 2015. “The story here is that you can fight back with strength in numbers.”
Amare said this week that she’s had concerns about patient and staff safety for years, but that the evening of Aug. 1 marked a tipping point for her.
She and her co-workers say on that night a patient in crisis left his room, stole a key card from a nurse and ran around the hospital, tearing up patients’ medical records and threatening anyone who approached him. Eleven Cascade staff members were injured while trying to calm the patient, including a 37-year-old mental health technician who left on a stretcher that night.
“I’m not in a place to tell you exactly what happened because there was so much struggle, but all I can say is that … I thought I was going to die,” the technician, Alazar Yirgu, said in an interview at the time.
Weeks after, Yirgu said he still had some trouble walking and remained on heavy medication.
“That was the last straw,” Amare said.
Cascade spokesperson Diana Chinea said this week that the hospital was also “very pleased” about the agreement and looking forward to welcoming employees back to work.
“This has not been an easy process for either side and we want to extend our appreciation to the Union and its negotiators for working in good faith to resolve the disputed issues,” Chinea wrote in an email. “Ultimately, we both want the same thing — to provide high-quality care to our patients in a safe environment that promotes hope and healing.”
This week’s resolution comes after 3½ months of growing tensions between workers and management — during which at least 24 workers were fired for striking, and the hospital installed a chain-link fence between the facility and the picket line.
In a move that added to frustrations in August, Cascade CEO Christopher West pushed back against staff claims in an open letter to the community, saying their labor union, SEIU Healthcare 1199NW, had “greatly exaggerated stories of unfavorable work conditions to bolster its contract bargaining objectives.”
At that point, striking workers had three demands of the hospital: Hire designated security guards, reinstate everyone who was fired, and stop retaliatory behavior against those on the picket line. In the agreement ratified Wednesday, Cascade agreed to all three.
According to the agreement, the hospital promised to hire three unarmed safety technicians, or security guards, for the day shift and two for the night shift, all trained in verbal and physical de-escalation strategies. It’s the first time the hospital has brought on employees specifically to respond to emergency situations, though Cascade has said all staffers had been trained in de-escalation and other safety protocols.
Hiring designated security, rather than relying on hospital staff to respond to fights and agitated patients, will make a huge difference, Amare said.
At Cascade when there’s a disruption, the hospital alerts the staff with a “Code Gray.” Because there aren’t security guards or a designated Code Gray response team, protocol instructs any staffers, including nurses, who can lend a hand to respond to the call to help with de-escalation.
“We didn’t have the resources to control the patients,” Amare said. “We are nurses. We have some training, but that training isn’t always enough.”
Under the agreement, the new safety technicians will have three to five years of security experience, be able to lift 75 pounds, support impact and trauma-informed care, demonstrate a “commitment to cultural competence” and be trained in verbal and physical de-escalation techniques.
The new contract also includes a 15% pay increase over three years and a $5,000 bonus.
Sara Moullin, an 11-year registered nurse at Cascade, said she and her colleagues were in tears when they finally returned to work this week.
“Walking in with all of our workers who have really fought hard for patient safety … and knowing we won was a great feeling,” she said.
Moullin was one of the first employees to be fired after the strike began and is eager to have her job back, she said.
“I missed my patients,” Amare added. “I wanted to see them. And I’m so ready, more than ever.”