News & Events

RNs at Steward Nashoba Valley Medical Center Overwhelmingly Ratify New Three-Year Contract

On Oct. 4, the registered nurses at Steward Nashoba Valley Medical Center (NVMC) in Ayer, who are represented by the Massachusetts Nurses Association (MNA), ratified a new three-year contract. The new contract includes important improvements that address the nurses’ long-standing concerns about nurse recruitment and retention, as well as nurse-to-patient staffing levels.


The ratification vote followed more than 10 months of negotiation sessions; a 100% strike authorization vote; community rallies; intervention from a federal mediator; and tremendous bipartisan support from the elected leaders who represent Ayer.


“Ratifying this contract means that we will be better able to care for our patients, their families, and the local communities we serve,” said Fran Karaska, RN and co-chairperson of the MNA bargaining unit at NVMC. “We now expect that Steward will be able to recruit retain the nurses we have needed for so long now, and that those new nurses will stay on at NVMC due to the many improvements — both patient-related and economic — that we won in this agreement.”


Contract improvements include:



  • Improvements to the nurse/patient staffing grids for the hospital’s three largest units:  the medical/surgical unit, the psychiatric unit, and the emergency department. The staffing grids set specific limits on nurses’ patient assignments based on the number of patients cared for on these units. This ensures that patients get proper care and monitoring from their assigned nurse.
  • Language stating that the minimum staffing in the intensive care unit will be two RNs when there is a census of two or more patients. Additionally, there is language stating that no RN will be disciplined for refusing to accept an assignment that is inconsistent with the state’s ICU staffing law. The ICU staffing law sets safe limits on how many critically ill patients a nurse can care for at one time.  Under no circumstances is it legal for a nurse to have more than two patients in an intensive care unit. 
  • Language requiring management to make every reasonable effort to meet the agreed upon staffing grids.
  • Language prohibiting management from diminishing any of the staffing grids.
  • Language requiring that management hire staff as necessary, and on an ongoing basis, in order to comply with all the terms of the contract


  • Retroactive wage increases over the next two years of, on average, 9% for full and part-time RNs, with the range being 6% at the start step and 15% at the top steps.
  • A 100% employer-paid defined benefit pension that will go into effect Dec. 1, 2021, until which time the 401(k) match continues.
  • A required $12 per hour bonus for nurses who work extra shifts.
  • Increases in shift differentials, including for ICU nurses who work evenings.
  • The ability for nurses to cash out vacation two times a year up to 80 hours annually
  • Maintenance of the health insurance cost splits and no increases to co-pays or any out of pocket costs or cuts to the benefits for the life of the contract.

 “This contract is a win for our patients and the local community, as well as for the hardworking nurses who are dedicated employees at NVMC,” said Audra Sprague, RN and bargaining unit co-chairperson. “It was a long fight to get here, but it was absolutely worth it. And we could not have done it without the support of the local community and our elected leaders."

The newly ratified agreement expires on January 1, 2022.