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Nurses say better pay and stronger retention efforts are needed to address staffing challenges and protect patient care.

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Brigham nurses voted in record numbers Tuesday to authorize a one-day strike, escalating a contract dispute with hospital leaders over pay, staffing, and what the union says are ongoing challenges in recruiting and retaining enough nurses to care for patients.

The nearly 4,000 registered nurses at Brigham and Women’s Hospital, represented by the Massachusetts Nurses Association, are now part of the largest registered nurse strike authorization in Massachusetts history. The results on Tuesday were 2,798 yes votes to 12 no votes. 

The vote comes after seven months of negotiations and 19 bargaining sessions. 

The vote does not mean a strike will occur, but it authorizes the Brigham nurses to schedule a one-day strike if necessary to secure a fair contract. If they authorize a strike, nurses will provide 10 days’ notice. 

The next bargaining session is on June 18. 

“We respect and value our nurses and remain committed to reaching a fair agreement,” Brigham and Women’s Hospital said in a statement. “Our proposal ensures every nurse receives a raise through annual step increases or a top-of-scale increase, while also preserving competitive health benefits, retirement support, paid time off, shift differentials, and professional development opportunities that are an important part of the overall package we provide.”

The hospital said it is prepared to provide safe, high-quality care if the nurses go on strike. 

The union said it called for the strike authorization after Massachusetts General Brigham executives proposed no wage increases for nurses below the top pay scale, sought to increase health insurance costs, and declined to include measures to recruit and retain permanent nurses.

“I am incredibly proud of Brigham nurses for standing up for our patients, our profession, and each other with this vote,” said Kelly Morgan, RN, a labor and delivery nurse and chair of the BWH MNA Bargaining Committee. 

Morgan continued, “We do not want to strike, but MGB (Mass General Brigham) executives have left nurses with little choice. You cannot claim patient care is your top priority while refusing to invest in the nurses who provide that care every day.”

In response, the hospital said it provides a 5% annual raise as employees progress through the 20-step scale. In addition, they are providing about 30% of the value of compensation through the benefits package. 

The only change to the proposed benefits is to the Harvard Pilgrim Health Care plan premium, and all the nurses are eligible to enroll in any of the medical insurance plans available to the rest of the employees without any change.  

The last time Brigham nurses voted to authorize a strike was in July 2024, when nurses were fighting to ensure safe patient care and quality working conditions. 

But this time around, Jen DeVincent, a labor and delivery nurse at Brigham’s, said that although patient safety is still top of mind, it’s about securing the pay needed to retain nurses — especially as other organizations in the region offer more. 

The nurses would also like to see a limit on the overuse of temporary travel nurses to help strengthen the continuity of care. The hospital said it already has a high retention rate of 3%, compared to 8.6% nationally. 

“Investing in the nurses is investing in patient safety,” DeVincent said. 

It’s about having enough full-time staff, less turnover, and supplies to make it happen, she said.

“It’s not just nurses dripping in dollars as Brigham is saying,” DeVincent said. “There’s a lot at stake.”