I think this organizing effort must have been divinely inspired," says one of the union leaders, a recovery room nurse. "I say that because after we started meeting, I started hearing from nurses at other hospitals trying to do the same thing." Nurses joined from emergency rooms, labs and med-surg units throughout Health Midwest, Kansas City's biggest health care system.

Many have long years of experience. Some are relatively new. They share a commitment to their patients and their profession and a belief that the voice of nurses must be heard if Health Midwest is to provide the high-quality health care its patients deserve. They call themselves Nurses United for Improved Patient Care. Said one nurse, "I'm not asking to run the show but I want to be consulted as a professional. I'm the one who's there by the bedside."

The Los Angeles Times reports that 20,000 nurses have joined unions in the last two years. All across the country, health care executives are trying to solve their budget problems on the backs of nurses and other health professionals who do the front-line work of caring for America. The problems are especially bad at for-profit corporations like Health Midwest.

When Health Midwest executives heard that nurses were getting together to form a union, their reaction was to hire a high-priced union-busting company. But the nurses have not been intimidated. They initiated discussions with several national health care unions and, we're proud to say, decided to affiliate with FNHP. They are now organizing at several facilities.

Here are some of their stories.

"They said, "Your figures are wrong." I said, 'They're not.'"
Teresa Barnett
Post-Anesthesia Care Unit, Menorah Medical Center

I believe RNs as front-line professionals will absolutely save health care from going straight down the tubes. People aren't scared anymore.

I got involved with organizing a union because we're looking at the disintegration of our profession. The spark came when we found out they were going to change the way benefits were calculated. I worked the figures on my computer and discovered that Health Midwest stood to save millions of dollars. The next day, they called a meeting to explain the change. A lot of people went. We had almost 30 packed into a small room. They were wide-eyed. They said, "We're just going to explain how to read your new pay stubs. There's no cut in benefits here." I told them what I had found out. They said, "Your figures are wrong." I said, "They're not. Get yours and we'll compare."

I contacted a lawyer who said, "You need to organize a union."

We formed a small group. When we spread our wings, people started coming to our meetings from other hospitals and even from other hospital chains. This is not just an organizing campaign, it's a movement. There's an underlying distrust of Health Midwest and of the health care system in general. Patients are not getting the care they need. We are told there's no money, yet the executives are making hundreds of thousands of dollars and getting big bonuses. It's health business instead of health care.

I always wanted to be a nurse, from when I was a little girl in Catholic school, fascinated by the big white habits of the nuns. As a nurse, I can use certain gifts--compassion, intelligence, sense of humor--to help people. It's a calling for me and for 98 percent of nurses. We certainly don't do it for the money.

"The new graduates coming out of school--I want them to have the same joy I had."
Kathy Todd
Recovery Room, Research Medical Center

I think this organizing effort must have been divinely inspired. I say that because after we started meeting, I started hearing from nurses at other hospitals trying to do the same thing. Nurses are unanimous in feeling we cannot take care of our patients properly and we have to do something about it.

We do have enough staff in the recovery room. But patients are coming to surgery not clean and not educated. After surgery, when I take patients out to the floors, I see a lot of discouraged nurses with seven and even eight other patients to care for. Health Midwest keeps boasting that they're the biggest, but their focus is not on patients.

I come from a long line of nurses. My grandmother, my mother and two of my sisters are nurses. I heard nurse talk at home. I read Florence Nightingale books. We lived near a busy street and when someone was hurt in a car accident, my mother took care of them. Neighbors came to her for help. I started working in a hospital when I was still in college 20 years ago. Those were the glory days when we had wonderful staffing and input as to how patients were cared for. I became the director of the critical care pulmonary unit at a great Lutheran hospital with a mission of caring for people. It was an absolute joy. We had the best unit in the hospital. Then Health Midwest took over and everything started to spiral downhill. They made it clear to me that my management style wasn't theirs. Finally I left management.

The new graduates coming out of school now--they have nothing to compare this to. I want them to have the same joy that I had, and the only way is if we can have a voice in what our patients need. Nursing is a great profession.

"Most of the managers at our hospital have had no exposure to unions and don't really know what they're dealing with."
Twyla Rolle
Emergency Room, Medical Center of Independence

I've been in nursing 37 years including 25 in administration.

I dealt with unions as an administrator in New Jersey and Chicago. I saw them as helpful, as problem solvers. Working with the union was a way to get consensus for change. The union was a way nurses could express what they wanted. It helped make change thoughtful. It eliminated capricious actions on both sides.

Most of the managers at our hospital have had no exposure to unions and don't really know what they're dealing with.

I left administration when managed care started making it impossible to give care the way I believed it should be done. Decisions were being made by insurance companies or the government, not by professionals. I wanted to go back to clinical work.

I took a $40,000 pay cut from being chief nurse for the Veterans Administration at a hospital in New Jersey. I truly believe that God has guided my work. I felt I needed to go back to taking care of patients. It was never about money.

A year and a half ago, I was one of six people who met with the state board of nursing because we were concerned about having to do things that could affect our licenses. We had nurses on med-surg who had 10 or 12 patients each. Or, someone would be pulled to the ICU with no background for it.

They told us these things could have a negative impact on our licenses, that we were on thin ice, but that there was nothing they could do.

Of those six, only I and one other are still nursing. The others left the profession.

I never dreamed that at this point in my career I would be out forming a union, but Health Midwest is a 16-hospital corporation and the bottom line determines everything.

A corporation will not comply with good standards of care unless it has to. That's why in California they passed a law to set staffing standards and why we need collective bargaining at Health Midwest.

"My number one goal for the union is to get better staffing."
Gerrie Jackson
Case manager, Baptist Medical Center

I have seen so many young graduates come here and get burned out because they are treated with no dignity. One nurse's supervisor said her job was a no-brainer. We go to school for three, four or five years to learn nursing and her supervisor told her this.

Nurses are told to do things whether they like it or not, and if they don't want to, they can find a job someplace else. That's why we decided to band together.

My number one goal for the union is to get better staffing. We may have one nurse with eight bedridden patients who need to be turned, fed and diapered. The patients have the right to safe, competent care. If you're taking care of eight patients and running back and forth answering phones, how can you be sure you're not making mistakes?

It's nice to have money, but you also need job satisfaction. You need to go home and say to yourself, "It was a hard day, but I know all my patients were cared for in the manner in which I would like to be cared for myself."

"I'm not asking to run the show, but I want to be consulted as a professional."
Anita Carr
Catheterization Lab, Overland Park Regional Medical Center

When I started work in 1991, my hospital was called Humana. I had a supervisor who went to bat to get better staffing, and she got it. They recognized the need and they met it. Things changed after the hospital was bought by HCA/Columbia and then by Health Midwest. They're cutting staff even though the patients are sicker.

The anti-union campaign can be intimidating. It's illegal for a supervisor to ask you what you think of the union but it's hard to look back at your supervisor and say, "You're breaking the law." But in a backdoor way, the anti-union campaign also validates what we're doing. It spurs nurses to want to get the facts and not just take what management says.

Actually, many of the supervisors are sympathizers.

With the union, we will have a voice in decisions that affect patient care. I'm not asking to run the show, but I want to be consulted as a professional. I'm the one who's by the bedside.

Then I hope to negotiate an agreement that specifically addresses issues such as staffing, floating and mandatory overtime. I have friends who have told me their experiences as patients at my hospital and it's very embarrassing. My department is good--we have enough staff--but as things are now, I could not encourage someone to stay here for general elective procedures.

I work part-time, so it's easier for me to be active in the union than some others. I'm proud to help my co-workers. I work with great nurses, a great group of people.

"If you don't have the time for education, that patient may end up in the hospital, in a nursing home, or dead."
Linda Ball
Visiting Nurse Services

Health Midwest expects us to work like slaves. Four or five years ago, they decided a visiting nurse could see 30 patients in 40 hours. Since then, the paperwork has become three or four times what it was. We work 60 hours a week and more with no compensation. We're so tired, we have no life except for work. We tell them, but it falls on deaf ears. The CEO told one nurse that visiting nurses just do this as a second job to enhance their husbands' income.

I do this because of the way people react when you help them. Even if you just set up a medication box to help them keep track of their 20 medications, they are so relieved and thankful. It's so rewarding. You get to know the patients and become part of the family. There is such love there.

A major goal of home health is to educate the patient to take care of himself or herself and keep out of the hospital. But now, with the Medicare changes, we're supposed to see patients as little as possible. If you don't have the time for education, that patient may end up in the hospital, in a nursing home or dead.

The patients have heard that the nurses are trying to get together and they're telling us, "You should have done it years ago."