Nearly 4,000 unionized nurses at Brigham and Women's Hospital began voting Thursday on Mass General Brigham's final contract offer. Ballots are due by 8 p.m. Friday. The result will show whether members accept the proposal or leave the dispute unresolved, with a strike still a possibility.
The vote comes after the nurses postponed an open-ended strike that had been scheduled for Oct. 14 so members could weigh in on the hospital's latest proposal, according to The Boston Globe. If members reject the offer, the Massachusetts Nurses Association-represented union says it will have to reevaluate whether to proceed with the indefinite strike it had already authorized.
This isn't the first time the two sides have clashed on the picket line. Brigham nurses held a one-day strike on July 8, followed by a four-day lockout imposed by MGB, according to the Massachusetts Nurses Association. During any future strike, nurses would forgo pay and the hospital's contribution to their health insurance premiums, per the Globe's reporting.
Why the Offer Is Splitting the Union
Union leaders say the hospital's final offer still does not address crucial disagreements over wages. The proposal, which the hospital has called its best and final offer and which would run through Sept. 30, 2028, would add a 2.5 percent increase at the highest salary level in the current wage scale, with another 2.5 percent increase effective Sept. 30, 2027, according to NBC10 Boston.
What the offer does not include, nurses say, is the across-the-board raise they argue is essential given inflation and the high cost of living in Greater Boston. The union had sought a 3 percent raise for the first six months of the contract and a 4 percent raise for the next 12 months, the Globe reports, while the hospital has not offered an additional across-the-board increase. Nurses already receive a 5 percent annual step increase on their hiring anniversary until they reach 20 years of service.
Kelly Morgan, the union's bargaining committee chair and a longtime labor and delivery nurse, said she doubted the offer would win ratification. The union nevertheless pushed for a vote so members could weigh the proposal themselves. Morgan told the Globe that nurses “have to have an active voice in saying what is right for them, and the city of Boston, and the patients that come and seek our care.”
Pay Scale at the Center of the Dispute
The salary figures offer one measure of the disagreement, though they do not settle the question of how the proposed raises compare across nurses' careers. Brigham nurses currently start at $86,700 annually, while those with 20 years of service earn at least $220,000, according to MGB figures cited by the Globe. MGB told the paper that 1,322 nurses, nearly one-third of the local union's membership, were already earning that maximum amount, and the health system maintains that its top-paid Brigham nurses are among the highest paid in Massachusetts.
Starting pay provides a different point of comparison. New-grad nurses start at $41.71 per hour at Brigham compared with $43.01 at Tufts Medical Center, according to the union's own figures reported by the Globe in its coverage of a separate contract fight. That dispute, involving nearly 2,000 nurses at Boston Medical Center, ended earlier this month when more than 80 percent of voting members ratified a new three-year deal. It included pay increases totaling $3.1 million more than management's previous wage proposal, raising first-year nurses' hourly wages from $38.05 to $42.63 over the first two years.
How this dispute fits into a wider context
A past Massachusetts strike offers a point of comparison, not a forecast: the Massachusetts Nurses Association reported that St. Vincent Hospital nurses in Worcester reached a tentative agreement on the 285th day of their strike in December 2021. That was a separate, much longer labor action; the cited account does not establish a comparable settlement or replacement-nurse arrangement. For broader context, the U.S. Bureau of Labor Statistics lists eight health care industry work stoppages beginning in 2022 and six in January–September 2023. Those historical national counts do not establish a trend or describe Brigham specifically. On staffing rules, the Massachusetts Health Policy Commission says state law limits registered-nurse assignments in hospital intensive care units to 1:1 or 1:2, depending on patient stability. The requirement applies to ICUs, not all hospital units.
Layoffs Add Pressure Behind the Scenes
The vote is unfolding against the backdrop of fresh cost-cutting at Mass General Brigham. Department leaders have been told to cut their budgets, and layoffs began the Tuesday before the vote, the Globe reported. Among those affected are some pediatricians at Mass Eye and Ear, though MGB said it offered affected practitioners positions elsewhere in the system. Health system spokesperson Jessica Pastore declined to say how many job cuts have taken place or are planned, according to the paper.
The cuts mark MGB's second round of layoffs in less than two years, according to Becker's Hospital Review, which reported the health system was running more than $300 million behind budget in fiscal 2026. MGB leadership has said administrative savings alone will not be enough and that programs and activities will need to be cut or redesigned. Separately, general pediatric inpatient admissions at Mass Eye and Ear are scheduled to transition to other Mass General Brigham for Children sites no later than Jan. 1, while the pediatric unit itself remains open.
For its part, Brigham has said its proposal values nurses' contributions to patient care while balancing its responsibilities to patients, its workforce, and the hospital's long-term financial strength. The hospital has also said it was obligated to give temporary replacement nurses five days of work, a commitment tied to the earlier lockout. With voting set to close Friday evening, nurses, hospital administrators, and patients across Boston are left waiting to see whether this latest offer holds, or whether the city's largest nursing union is headed toward its most consequential strike yet.
