UnityPoint Health nurses in Des Moines have filed complaints with federal labor officials against the health system, accusing hospital administrators of trying to illegally discourage their union efforts.
Nurses at the four UnityPoint Health hospitals in Des Moines have announced their intention to organize a union through Teamsters Local 90 because of their discontent over nurses' compensation and working conditions.
Staff behind the union effort say hospital policies on pay has hurt nurse recruitment and retention, resulting in staff shortages. That, they contend, has in turned threatened to compromise patient safety.
Nurses are still collecting the signatures required to trigger a vote to form the union. If collective bargaining with the health system is ultimately successful, organizers say the union would represent about 1,550 nurses at Iowa Methodist Medical Center, Blank Children's Hospital, Methodist West Hospital and Iowa Lutheran Hospital.
Organizing nurses told the Register the health system has ramped up its effort to discourage the union in recent weeks.
Teamsters Local 90 filed three charges with the National Labor Relations Board against UnityPoint Health last month, accusing hospital leadership of taking coercive actions to undermine their union efforts. The accusations say the health system maintained illegal and overwrought work rules, intimidated workers and removed and destroyed union materials, said Tanner Fischer, president and business agent for Teamsters Local 90.
Teamsters declined to provide documentation of the charges, citing privacy concerns.
But nurses described instances of union organizing posters in staff breakrooms being taken down, and even torn up, by management.
They say staff who attempt to set up tables in public spaces of the hospital to spread the word about the union are met by arbitrary rules from leadership meant to infringe on that effort. In at least one case, nurses were threatened with being kicked off campus if they attempted to set up a table on hospital grounds.
Federal law bans employers from "interfering with, restraining or coercing employees" who are taking part in efforts to organize or join a labor organization.
"We are aware of the recent charges filed by the Teamsters with the National Labor Relations Board," Sarah Brown, UnityPoint Health system chief nursing officer, said in a statement.
"We are confident these charges are without merit and will be dismissed once reviewed by the NLRB."
The health system has hired third-party consultants to hold informational sessions about unionizing to hospital nurses. These firms have worked with hospitals and other health care organizations across the country whose workforce is pursuing union efforts, according to reports filed with the U.S. Department of Labor.
But Fischer said these firms are "union busters" whose sole task is to deter nurses from organizing.
"Essentially, the union busters show up and they try to make nurses lose confidence in what their initial goal was, which is working together to try to improve their own working conditions," Fischer said. "They will do anything from lie to people or just sow doubt and fear."
Federal reports show one of the consulting firms, the Crossroads Group Labor Relations Consultants, charged $450 an hour in November to a New Hampshire hospital whose nurses were organizing.
Another firm, C. Hunt Management Consulting, charged a Connecticut hospital $300 an hour to consult on "campaign work for union avoidance" in 2022, according to federal reports.
UnityPoint Health confirmed it has hired national labor relations experts, stating their purpose is to help the system navigate its responsibility "to ensure all nurses are fully informed about their rights, the law and the potential impact of union representation."
"We know our nurses are facing pressure to make rushed decisions about unionization that will have a significant impact on their professional lives," Brown said in a statement. "We believe it is our responsibility to ensure our nurses are fully informed about their rights, the law and the potential impact of union representation. To assist in this educational effort, we have engaged experts in the NLRB election process and union representation to provide guidance to our nurses on their rights, answer their questions and help them make informed choices."
Whitney Armstrong, a union organizer and a critical care nurse at Iowa Methodist Medical Center, said nurses are pursuing a union because there's little faith that hospital administrators will make the changes needed to address their ongoing challenges.
She said many nurses have brought concerns to management over the years, yet little has been done to address them.
"We're doing this to make things better for our patients and make things better for our families, whereas the motivation on the other side is to continue putting money in their pockets," she said.
More: 'Just a start': UnityPoint nurses try to unionize 1,550 coworkers over pay, work conditions
Morale among the nursing staff is at an all-time low, according to UnityPoint Health nurses who spoke with the Register.
They say recent policy changes made to reduce nurse compensation has prompted fears that more nurses will choose to leave the system. More nurses leaving the bedside will further exacerbate staff shortages that have plagued the system for some time and raises questions on how the hospitals will be able to care for growing patient demands.
Within the system, Armstrong said hospital leadership has created "a constant system of asking (nurses) to do more with less."
"We want the hospital to be better staffed, because we know that safe staffing saves lives," Armstrong said. "It isn't that there's a nursing shortage, there's a shortage of nurses that are willing to do the work for lack of pay. That's really what this is about. It's about getting more nurses to the bedside so that we can take better care of our patients."
UnityPoint Health officials acknowledged these challenges in a statement, stating officials "care deeply about our nurses and value their voices."
"We understand the increasing demands they face, and we are investing significant time, energy and resources to preserve our collaborative culture and help nurses feel valued and engaged," Brown said in a statement. "Like other healthcare systems across the nation, we face staffing and turnover challenges in our nursing workforce. We are committed to addressing those challenges by enhancing the nursing experience through investments in compensation, technology and workplace safety."
As they seek support for their effort within the hospital, more nurses are publicly sharing their experiences to illustrate why they say a union contract is a necessary step to address ongoing challenges they see day-to-day.
Critical care nurse Belinda Carpenter was approached a year ago by patient safety personnel, who informed her that she was the shift leader at the hospital emergency department when a patient with suicidal ideation arrived. That patient eventually went home without being seen by medical staff and died by suicide later that day.
Carpenter said she remembers responding that they'd have to be more specific. People with suicidal ideation leave the emergency department without being seen all the time, she recalls telling the patient safety personnel.
While Carpenter feels immense guilt over the loss of that patient, she said she also knows there was little medical staff could do to alleviate pressure. More often then not, the hospitals' emergency departments are "busting at the seams" with patients needing care, but many are forced to wait.
"It made me feel awful, because the patient came to us for help, and we didn't do that for them," said Carpenter who works at three of UnityPoint Health-Des Moines's four hospitals' emergency departments and critical care areas. "And as a result, they lost their life. That type of stuff is happening way too often."
Many parts of the hospital are short-staffed and slow to admit new patients, she said, which means the emergency departments often become overcrowded.
Patients in mental health crisis routinely are boarded in the emergency room for days. Patients have gone into pulmonary arrest in the lobby waiting for a doctor. Even those brought to the hospital in ambulances will have to sit in the waiting room, she said.
It's these moments that have prompted Carpenter to join the ongoing union effort.
"The reason I'm doing this -- and I think most of us are -- is just so we can give the patients the best care that we are able to give them, and to get more tools so we can have better outcomes for them," Carpenter said. "At the end of the day, I want to go home feeling like I did a good job and took care of people the best way that I could."
Nurses who spoke to the Register say nurses' lack of adequate compensation is a driving fact for high turnover. Union organizers have pointed to some estimates that show Iowa ranks 48th in the nation for the average salary of a registered nurse working in the state.
The announcement about the union effort came shortly after UnityPoint Health officials changed its policies around pay for shift differentials. As a result, nurses saw hundreds -- in some cases, thousands -- of dollars cut from their paychecks each year, according to union organizers.
Dawn Balek, an overnight nurse at the post-surgery recovery room at Iowa Methodist hospital, said three nurses on her unit resigned the day after leadership announced the change.
Balek said nurses in the recovery already struggle to keep up with the task of caring for patients from as many as 70 surgeries a day from the hospital's operating room, and the cut to their paychecks was the final straw.
"At some point, the nurses are just fed up," she said. "We've worked really hard over the last few years, more so than we planned on with COVID-19. Nobody plans a pandemic. But then to come back and have them start taking stuff away from you just doesn't work, especially when you've worked your butt off for them."
Nurses involved in the union say they are asked to do more with less resources. To make up for lack of staff, nurses on some floors are expected to take on more patients each day, which can affect the quality of their care.
Jessica Golay, an emergency department and ICU nurse at Iowa Methodist Hospital, said she sees patients hurt by delayed care because of staff shortages.
She recalled one recent instance of two patients arriving to the emergency room with active heart attacks. Because the hospital's cardiac catheterization lab was short on nursing staff, a doctor had to choose which patient got to receive treatment first.
"It's not just about the pay, its honest-to-God about patient safety," she said.
Savannah Deupree, medical-surgical nurse at Iowa Methodist and Methodist West hospitals, said she and other nurses are constantly getting text messages from hospital management asking nurses to cover extra shifts. Deupree received such a text message during her recent interview with the Register.
The unending cycle of being asked to work additional hours at the bedside to make up for short staffing is draining on nurse's mental health, she said.
"They are constantly stretching and asking us to do more with less," Deupree said.
Michaela Ramm covers health care for the Des Moines Register. She can be reached at [email protected] or at (319) 339-7354.