Nurse practitioners and physician assistants at Legacy hospitals and clinics reached a second tentative agreement Dec. 30, ending their strike before a ratification vote was completed.
The unit of 135 workers represented by Oregon Nurses Association (ONA) had been on strike since Dec. 2. ONA said Dec. 30 that members would return to work in the coming days.
The workers are advanced practice providers (APPs), a category of medical providers whose training and responsibilities are between those of nurses and physicians.
ONA announced on Christmas Eve that the union and Legacy had reached tentative agreement on a first contract.
After a vote on Dec. 26 and 27, ONA said the first tentative agreement was “resoundingly rejected” by members but declined to share vote results. That agreement wouldn’t have brought Legacy providers’ compensation up to par with the same positions at OHSU or other health care systems, ONA said in a Dec. 27 press release.
The rejected agreement included a wage scale ranging from $72.84 to $103.37 per hour after ratification, which was what Legacy was offering before the strike started. But it also included more frequent raises, meaning hourly wages at the end of the contract term would have been more than $2 higher than what Legacy had previously offered.
The second tentative agreement made more significant improvements, including faster raises, increased pay for night and extended shifts, and the creation of a labor-management committee.
ONA said the union and Legacy had agreed to a 90-day cooling-off period. That means that even if the second tentative agreement isn’t ratified, workers won’t go right back out on strike.
Legacy had previously notified the union that it would cancel health insurance for striking workers effective Jan. 1. If the strike had continued well into January, workers would have been eligible to receive unemployment benefits. A new state law extending unemployment benefits to striking workers goes into effect Jan. 1, but workers will have a two-week waiting period before they can receive funds.
Jon Van Horn, a physician assistant in trauma and critical care, told the Labor Press on Dec. 22 that it pained him that the strike was putting a burden on colleagues inside the hospitals. Conditions for workers and patients inside hospitals have been strained during past nurse strikes, even with an established market of travel nurses available for strikebreaking positions. Some temporary APPs have been brought in at Legacy, but the striker replacement workforce for those roles isn’t as abundant as for nurses.
Strikers say they’re hearing from coworkers who are not on strike that care has been delayed, providers have had to fill roles where they have less experience, and patients have undergone higher-risk procedures because staffing was inadequate to carry out safer ones.
Solidarity strikes
The bargaining unit started with nearly 50 workers who unionized in January 2024 and added in another 90 in August 2025.
Around 80 more APPs joined the striking group for two-day solidarity strikes before the tentative agreement was reached.
“We needed the boost, quite frankly,” said striking nurse practitioner Christine Lasich.
At a Dec. 22 rally outside Legacy Emanuel Medical Center, Van Horn thanked solidarity strikers for “sharing in this suffering together.”
They included about 50 at Legacy GoHealth urgent care clinics who unionized in January 2025 and 30 pediatric APPs who unionized in August 2025. The pediatric providers have yet to start bargaining.
“We have the same issues with unpaid work time, burnout, wildly disparate compensation,” pediatric nurse practitioner Erin Warren told the Labor Press. “We have the same fight ahead of us that they’ve already been trailblazing for the last two years.”
