UnityPoint Health nurses in Des Moines plan to form a union over wages
More than 50 nurses turned out in chilly conditions Tuesday afternoon to show their support for unionizing Unity Point Health nurses in Des Moines.
“As nurses, we are told we are the backbone of this institution. However, we are given little to no power to impact decisions and policy changes that impact our ability to safely care for our patients, steer the health of our workplace and affect our own personal livelihood,” said Cassie Freml, a registered nurse with Unity Point at Tuesday’s rally.
The nurses say they intend to form a union over their concerns about compensation, working conditions and patient care through Teamsters Local 90.
If successful, union organizers say the union would represent 1,550 nurses in Des Moines. With more than 600 signatures already in hand despite the campaign having just started, RN Carly Olney said she was hopeful the nurses would be able to vote on unionizing “within a month or two.”
In a statement Tuesday evening, UnityPoint Health System Chief Nursing Officer Sarah Brown said hospital officials “understand and deeply empathize with the frustration that some of our nurses are feeling.”
“We acknowledge that recent challenges have left some of them feeling unsupported, and we take full responsibility for that,” the statement said. “… We are committed to making meaningful changes to address their concerns and improve the experience for all of our nurses.”
It may be too late.
A Facebook page, United Nurses of Iowa, was created two weeks ago and had 804 members by late Tuesday afternoon, including 780 new members in the last week.
“We’re really excited about what (the union) can do for our patients and our ability to care for patients better and be the nurses that we envision ourselves to be,” said Whitney Armstrong, a union organizer and a critical care nurse at Iowa Methodist Medical Center.
“Unity Point has treated us as if we are disposable labor,” Olney said.
Some of the changes that have been made including shift differentials have resulted in some nurses getting paid thousands of dollars less, Olney said, while being told by management that the money is not there to increase nursing salaries.
“But they line their own pockets with money and give themselves bonuses that total the amount that we would make in one year’s salary. Nurses are left then to make difficult decisions on whether or not they stay at the bedside to protect our patients and support our coworkers of if they leave the bedside all together so that they can support their families and themselves.
“Some nurses stay out of guilt over this and many nurses leave and continue to leave, making the workplace unsafe,” Olney said.
Olney said the hospitals have the same number of patient beds with fewer nurses and fewer nurses that have been trained to take care of some of the high aquity patients.
“RN’s shouldn’t be forced to work under these conditions, and your loved ones don’t deserve anything less than excellent care,” Olney said.
“To add insult to injury, we’re told that our patient surveys could be better and that we should do better and then maybe we could get increased raises. But how are we supposed to have better surveys if our staffing ratios are not safe and we cannot properly provide for the patients?” said Olney,
At Tuesday’s rally, Tanner Fischer, president and business agent for Teamsters Local 90, reminded nurses that it is illegal for an employer to retaliate or threaten to retaliate against workers forming a union.
“We will give workers a voice in these hospitals that has long been ignored. It has been an honor to work with this fine group of nurses and heroes who look forward to negotiating a contract that values the hard work they do every day,” Fischer said.
Alano De La Rosa, secretary-treasurer and principal officer for Teamsters Local 90, said the union was recently successful in organizing 10,000 nurses in Michigan and is hoping for further health care gains in Iowa.
“I’m hoping what we are seeing here (Tuesday’s rally) is just the start,” De La Rosa said.
Brown said UnityPoint Health officials are committed to working directly with nurses to address their concerns, learn their feedback and “to make the changes necessary to create a better workplace.”
“At the same time, we are immensely grateful for the many nurses who feel supported and fulfilled in their work here,” Brown said in a statement. “Together, we will continue to build an organization that fosters a culture of respect, collaboration, and excellence in patient care—one where every nurse can feel proud of the work they do, and one that provides an exceptional experience for the patients, team members, and communities we serve.”
Here’s what to know about the effort:
Which groups are looking to form a union?
Nurses working bedside at the four UnityPoint Health hospitals in Des Moines — Iowa Methodist Medical Center, Blank Children’s Hospital, Methodist West Hospital and Iowa Lutheran Hospital — are in the early days of forming a union in response to their dissatisfaction over patient safety and nurse compensation.
Nurses have partnered with Teamsters Local 90, the Des Moines-based labor union. Currently, union organizers are working to garner enough support from their colleagues to file a petition with the National Labor Relations Board.
If the union receives majority support in an election, the union would be certified to begin collective bargaining with health system officials to establish a contract.
Why do nurses want to unionize?
Armstrong said nurses lack a “fair and transparent wage system” that helps staff understand what they can expect to take home. At the same time, UnityPoint officials have made a series of changes to nursing pay that have meant many nurses are taking home less pay than they used to, organizers said.
Recently, hospital officials changed policies around pay for shift differentials, Armstrong said. Previously, nurses would get extra pay for every hour they worked outside normal businesses hours, such as the early morning or night shifts.
Now, hospital policy dictates nurses must work at least four hours within those shifts to qualify for that additional pay.
The change has meant nurses who are scheduled to work one to two hours in an early or late shift are taking home $5-$7 less an hour, organizers say. As a result, many nurses’ paychecks have been cut by thousands of dollars. Armstrong said one nurse calculated that she was making $2,800 less a year as a result.
This comes when nurses in Iowa already make less than their counterparts in other states, organizers say. A ranking compiled by Nurse.org using U.S. Bureau of Labor Statistics data shows Iowa ranks 48th in the nation for the average salary of a registered nurse working in the state.
What concerns do nurses have over patient care?
In addition, top health system officials have implemented policy changes that have meant nurses are tasked with caring for more patients during a shift, nursing organizers say.
These increased staffing ratios have raised concerns among medical staff about patient safety, Armstrong said. In some cases, nurses were responsible for overseeing the care of 10 patients on a unit. The American Nursing Association recommends the maximum patient to nurse ratio should be 5-1.
“There was a time in COVID where we were able to cap the number of patients that a floor would accept based on that staffing,” Armstrong said. “But that practice has been stopped now, so they can’t cap, which is forcing nurses to take sometimes between 10 and 12 patients at night.
“That one nurse is only able to spend five to six minutes an hour with a patient. So that results in total nursing care that patient receives is 60 minutes in a 12-hour shift.”
UnityPoint Health officials have said that these staffing changes are necessary because of ongoing nurse shortages, but Armstrong said the lack of good pay is driving nurses away from the hospitals.
“We became nurses to take care of patients, and that’s what we want to do,” Armstrong told the Register. “That’s why we work at the hospital, to be bedside and take care of patients. But as patients are getting sicker and sicker, it’s become more and more difficult to do that, because the reality is, nurses are leaving the bedside because there aren’t enough of us at the bedside willing to do the work without the pay and the support of our employers.”
What do UnityPoint Health officials say about the nurse’s concerns?
In her statement late Tuesday, Brown addressed the nurses’ concerns around pay and staffing:
“While we have made significant strides around investment in nursing wages, we are committed to being more transparent and proactive in the future with how we communicate compensation-related changes. We are also committed to creating a sustainable, supportive environment for our nurses – with our annual engagement survey results showing a significant increase in every single employee engagement category. When adequate staffing has been a challenge, we’ve worked to innovate in care delivery to ensure safe staffing levels and adapt to the needs of our caregivers. For example, we implemented our virtual nurse program—one of the first of its kind in the nation—and received overwhelmingly positive feedback.
Like many health systems facing constraints, we have been working on reducing our reliance on contract labor because we believe that our own team members—those who are part of our community and share our values—are best positioned to provide the consistent, compassionate care our patients deserve. We are doubling down on efforts to grow and support our nursing workforce as well as invest in professional development through the advancement of our journey towards Magnet designation across the health system, a program that puts nursing shared governance and decision-making at the center of nursing practice. Earlier this year, we also stood up our first system-wide nurse advisory council to share in decision-making about the things most important to our team members.”
Is union representation for nurses rare?
Nationally, about 20% of registered nurses (RNs) and 10% of licensed practical nurses (LPNs) have union representation, according the U.S. Bureau of Labor Statistics.
The Health Care Teamsters website states that it has about 35,000 health care members across the United States but does not break down how many of them are nurses.
National Nurses United is the largest nurses union, with more than 225,000 members, according to its website.
Nurses at University of Iowa Hospitals and Clinics and Finley Hospital in Dubuque are represented by Service Employees International Union (SEIU) of Minnesota and Iowa.
Is union representation for nurses expected to grow?
In an earlier interview with the Register, Paul Clark, a professor of labor and employment relations at Penn State University said he anticipates growth in unionization efforts among nurses.
“Employees in health care are organizing at significant rates,” Clark wrote in an email to the Register. “This trend is even extending to physicians who are employees of health systems and hospitals as the percentage of doctors in private practice rapidly declines when investors buy out physician practices. The physicians who work for Allina in Minnesota recently organized one of the largest physicians’ unions in the country.”
In the case of unionizing efforts with nurses, working conditions can be as important among negotiating issues as wages, according to Clark.
“Unions are using their current leverage to also focus on addressing the very difficult working conditions health care employees are working under. In the case of nurses unions, they are focusing on increasing staffing to reduce the stress and moral injury (the experience of negative emotions like guilt, shame, contempt, and anger that result from a violation of one’s moral values) that nurses and other health care workers are experiencing,” Clark wrote.
Michaela Ramm covers health care for the Des Moines Register. She can be reached at [email protected] or at (319) 339-7354.
(This story was updated because an earlier version included an inaccuracy.)
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