Yet another group of crucial workers is just days away from a nationwide walkout.

More than 75,000 workers at one of the nation's largest health care providers, Kaiser Permanente, could go on strike next Wednesday if there's no agreement between their unions and their employer. A final round of in-person negotiations is scheduled to start on Friday, before the current contract expires on Saturday.

The three-day strike would hit hospitals, clinics and medical offices from California and Colorado to Washington D.C. Tens of thousands of workers — including nurses, lab technicians, pharmacists and therapists — would walk off the job.

Kaiser serves nearly 13 million patients across the U.S. A coalition of 12 unions has been in talks with the organization since April to iron out a new contract for its members. The Coalition of Kaiser Permanente Unions says it's still far apart from Kaiser on key issues such as pay raises and job protections.

If workers walk off the job, it would be what their unions describe as the biggest healthcare strike in U.S. history. Like striking workers in many other industries, they, too are demanding higher pay and better benefits.

Staffing crisis

But the Kaiser strike threat is primarily driven by a colossal understaffing crisis. An exodus of health care workers due to COVID-19 – coupled with a surge in demand as patients return for routine care they had delayed because of the pandemic – has heightened the severity of the staffing shortage, according to Caroline Lucas, executive director of the union coalition.

"We went from really having a problem on the horizon to having a crisis here and now," Lucas said.

Lucas said understaffing was a concern even before the COVID-19 pandemic. But she said Kaiser executives "kicked the can down the road," at the same time that the pandemic hit the U.S.

So now, workers from coast to coast are preparing to stage an unfair labor practice strike in response to what they see as unfair bargaining from Kaiser to resolve the staffing shortage. It would be the 18th major strike in the U.S. so far this year, according to Cornell University's School of Industrial and Labor Relations.

Appointment wait times for patients have skyrocketed

Workers say this shortage in staff has deteriorated the quality of care for Kaiser's patients and harmed employees' well-being. About 11% of union positions were vacant in April of this year, according to Kaiser data obtained by the unions.

Pamela Reid, an optometrist at Kaiser's Marlow Heights Medical Center in Maryland, said wait times for an appointment in her department ranged from five to 10 business days before the COVID-19 pandemic. But now, patients often have to wait two months, she said.

And the number of optometrists across Kaiser's service regions, Reid said, has dropped from about 70 to fewer than 50.

"(Patients are) really already being affected," Reid said. "So our goal with the strike is to hopefully change that."

Better pay and benefits will help with retention, unions say

The coalition is pushing for a pay raise of nearly 25% for all of its members along with better benefits, such as more investment in training for current employees and medical coverage for retirees.

With better pay and work conditions, they say, more people would be incentivized to stay at Kaiser. It would also attract newer workers — all of which would help alleviate the staffing shortage.

Kaiser has offered raises ranging from 12% to 14%, according to the unions. The unions also say Kaiser has so far refused to renew subcontracting and outsourcing protections.

Kaiser said in a statement that it's close to reaching its goal of hiring 10,000 more people by the end of 2023 to fill vacant roles.

But Lucas said the organization isn't taking into account the thousands of workers who keep leaving. Kaiser, she added, needs to raise wages to give people a reason to stay.

"(Some Kaiser employees) work 40, 50, 60 hours a week at a job that we all know as a society that we need to have filled," Lucas said. "And they can't pay their bills at the end of the week."

Kaiser said it offers better pay and benefits than other health care employers. The organization is asking employees to reject calls to walk off the job to prevent harm to patients, while stressing that it has plans in place to keep providing care in the event of a strike.

Kaiser also said it's working to reach an agreement with the unions that "protects and improves all these great advantages of working at Kaiser," citing progress in national bargaining over the past week and steps the organization has already taken to streamline the hiring process.

"We are committed to addressing every area of staffing that is still challenging," Kaiser said in a statement.

"Kaiser is already letting down our patients"

For Brooke El-Amin, the staffing shortage has taken a huge toll.

In her 21 years at Kaiser, she has moved up through the ranks. El-Amin has held several positions in the Washington D.C. area, from technician and outpatient pharmacist to acute care clinic pharmacist.

"Kaiser really grew with me for all of those years," the 39-year-old El-Amin said, adding that she can't imagine her life without the organization.

But she started to notice changes when the COVID-19 pandemic hit the U.S. in 2020. That's when the place where she built her career no longer seemed to have her back.

Working as an outpatient pharmacist in the early weeks of the pandemic, El-Amin said severe levels of understaffing negatively affected her mental health each day. She showed up every morning not knowing how many technicians would call out of work – and how much stress she'd be under to still meet quotas, despite having less support.

"I don't want to strike," El-Amin said. "But I feel like Kaiser is already letting down our patients – they're already letting down the employees."

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