Outside of Ascension Saint Agnes Hospital, a crowd of nurses stood along Caton Avenue on Thursday. They smiled, cheered and waved signs that read: “Honk if you support nurses + patients over corporate greed!” “No more forced overtime!” and “We love our patients.”

A passing car paused in its tracks, and the driver asked why the crowd had formed. A nurse in blue scrubs said, “Saint Agnes registered nurses are on strike.”

The unionized nurses, represented by National Nurses United, held a 24-hour strike in Baltimore that will end at 6:59 a.m. Friday. They came with a shared goal: to demand better working conditions and push Ascension, the private Catholic health care system that runs hospitals nationwide, to meet their contract demands.

Since January 2024, Saint Agnes has been negotiating a contract with Ascension, after the nurses voted to unionize in 2023. The union wants hospital management to hire more nurses and eliminate the need to place them in departments in which they have not been trained.

But Ascension isn’t moved by these concerns, said Robin Buckner, a nurse who works in the hospital’s IV therapy department.

“They have been dragging their feet,” Buckner said. “We’re here for our patients … we were hoping we wouldn’t have to come to this point, that they would work with us in good faith, but it doesn’t seem like they are.”

Buckner, who’s worked as a nurse for 46 years — more than 10 of them at Saint Agnes — said the hospital ran more efficiently and patient care was better when it was fully staffed. Now, she said, patients suffer delays in getting pain medicine, help to the bathroom, or having their calls answered.

“Any aspect of their care is on delay because the nurses are tending to another patient who is just as sick,” she said.

Throughout the morning, drivers beeped and truckers tooted their horns in solidarity as they rolled down the street.

Alexandra Otto, who has worked nearly five years in the intensive care unit, came straight from an overnight shift to join her colleagues at 7 a.m. She said caring for patients at Saint Agnes fulfills a dream she’s had since age 3. Growing up, she helped care for her diabetic grandfather.

“I’ve always had a passion for helping people. I’ve never felt like there was something else that I could do,” she said.

Otto said it deeply troubled her when she couldn’t give patients the care they deserved. At other hospitals, she’d seen management take more responsibility and provide better resources.

“I don’t want my patients to feel like they have been neglected, or something could have been done more to help their family who passed,” Otto said.

In a statement to The Baltimore Banner, a Saint Agnes spokesperson said the hospital remained open and was fully operational throughout the strike.

The spokesperson added that Saint Agnes looks forward to ensuring safe staffing, providing competitive wages and to the union “returning their focus to negotiations so we can continue to bargain in good faith and advocate for a contract that allows our nurses to have the choice on whether or not to be dues-paying union members.”

State delegates and community members stopped by to show support, including Del. Aletheia McCaskill and Del. Kim Ross, who encouraged the nurses to keep fighting and said patient safety remains a top concern.

“You all nurses represent the largest group of health care professionals in the country, so you all have the power. Is that right?” Ross asked, prompting a loud “Yeah!” from the crowd.

“So lean into that. You’re exercising your power. You’re raising your voices,” she continued. “I’m proud to stand here with you. So make no mistake about it. This isn’t about targeting any particular person [or] organization… this is about safety,” Ross said.

Brea Ross, 25, of Baltimore, said supporting the Saint Agnes workers hit close to home because she has friends studying to become nurses.

“I believe registered nurses help doctors. [Doctors] need the assistance, and if your resources are being spread too thin, then what are you supposed to do?” Ross asked. “You can’t do anything.”

Nicki Horvat, a neonatal ICU nurse at Saint Agnes for eight years, said the profit-driven health care system often limits nurse staffing — leading to burnout and a loss of passion.

“I started on the adult medical surgical unit with orthopedics, and I left that unit because I was constantly having anywhere from five to seven patients every shift,” Horvat said. “Having that many people in a 12-hour shift, you’re pulled in so many directions. You can’t sit with the patient or dig really deep to see what’s going on. It really wears on the nurses’ souls.”

In 2024, unionized nurses in hospitals managed by Ascension in Texas and Kansas ratified their first contracts after striking. Horvat said the nurses’ wins gives her hope that Saint Agnes can also reach a suitable contract.

The crowd of nurses and supporters turned toward the hospital and waved to their colleagues who were watching through the windows. From inside, the nurses waved back.