Unionized workers say they are fighting for higher pay and better working conditions, including improved nurse-to-patient ratios.

Almost 5,000 Oregon healthcare workers are striking against nonprofit health system Providence after more than a year of failed contract negotiations. | Though largely comprised of nurses, the walk-off that began Friday also includes physician associates and doctors—the latter of which is a first for Oregon,

The strike comes on the eve of Trump’s inauguration and the impending escalation of attacks on public health, medical workers and the working class as a whole.