Recent victory in Missouri pivotal for Nurses United's multi-hospital campaign 

How do you fight a powerful corporate heavyweight with deep pockets and a "nurses don't count" management philosophy? One hospital at a time.

In the past year, despite an anti-union campaign in which health care conglomerate Health Midwest spent $2 million on anti-union consultants and violated labor law to the tune of more than 100 unfair labor practices, Nurses United/AFT Healthcare has triumphed in three hotly contested elections in and around Kansas City, Mo., where Health Midwest operates a 15-hospital chain. A David to Health Midwest's Goliath, Nurses United has now organized unions at Lee's Summit Hospital, Menorah Medical Center, and, most recently, the Medical Center of Independence, where this July nurses voted nearly two to one for collective bargaining.

This August, Nurses United also won a crucial National Labor Relations Board ruling that orders the company to stop a wide range of anti-union activities in its hospitals (see sidebar for details).
 

The sweet smell of victory

"I wish I could replay that moment over and over again," says Mary Nash, a 16-year veteran ICU nurse at the Medical Center of Independence. "The NLRB agent looked up and said, 'You have a union.' We were cheering. Some of us were crying. Health Midwest had been so very sure they were going to win."

MCI emergency room nurse DeAnna Edwards recalls, "Nurses came from Lee's Summit and Menorah, and we felt such support from them. I've kept the piece of paper I was tallying the votes on as they were read out, to remember the day by."

MCI nurses say that they stayed the course because, like many of their colleagues throughout the Health Midwest system, they've come to see that only a union voice will change things at their hospital.

"This campaign began because of dangerous understaffing," Nash says. "We come to work fearful of making mistakes because we have too many patients, the patients are sicker, and we're stretched beyond reasonable limits. We're fearful that we'll miss something or make a mistake that will cost someone their life. Often we say, 'We had a guardian angel on our shoulders today.'"

Nash adds, "There are times in our unit when we have to forego brushing teeth and giving a bath because we have to set priorities. Recently a nurse told me that she had been able to turn her ventilator patient only once during her shift. How can we be silent about these issues?"

Cheryl Thompson, an MCI RN who moved from the ICU to recovery, remembers, "In ICU, we'd call supervisors when we were understaffed and they'd just throw up their hands. We were making suggestions to resolve problems and instead of listening, they'd threaten us with mandatory overtime."

Conditions in other units mirrored the troubles in ICU. For example, nurses in the medical-surgical unit reported nurse-patient ratios as high as 1 to 12 on the night shift.

E.R. nurse DeAnna Edwards sums it up: "I got involved with the union because I've been at MCI since 1976 and it wasn't always like this. Before Health Midwest came in, we nurses felt as if we counted. Now the hospital doesn't listen to us anymore. It's all about big business."
 

Millions spent on union-busters

The Medical Center of Independence is among the most top-heavy, in management dollars spent, of any of the facilities in the Health Midwest chain. That's saying a lot in a hospital system that in 1998 reported to the IRS that between 27 percent and 45 percent of its total spending goes to management expenses. Yet Health Midwest CEO Dick Brown wrote nurses in a June 2001 "open letter" that financial constraints "make it difficult to deliver the high-quality health care we all want to provide."

At a time when Pitch, an alternative weekly newspaper in Kansas City, reported that Health Midwest hospitals had a pattern of running out of syringes, IV start kits, dressings, chest tubes, and even gloves, the chain gave Brown a $450,000 raise in 1999.

In the MCI election, the hospital's anti-union campaign featured the usual threats and warnings from the union-buster playbook. "The anti-union campaign was so cookie cutter," recalls recovery nurse Cheryl Thompson. "I've gotten to know nurses at other hospitals, and I could tell people on my unit that this was the same old stuff they did at Menorah and at Lee's Summit. When you know that [management] is just trying to push your buttons, it takes some of the sting out of it."

Management passed out flyers warning that voting for a union would mean a strike. They held meetings in which management's lead negotiator painted a very bleak picture of the Lee's Summit bargaining process.

In the end, the hospital's barrage of anti-union propaganda was just a waste of paper and consultants' fees. Pro-union nurses crowded the MCI cafeteria as votes were counted on the evening of July 3. The final tally: 93-47 in favor of the union, nearly a two-to-one victory at a hospital where management had been confident that the union was toast.

"I feel as if this victory could be pivotal in organizing the Health Midwest chain," says Nash. "People all over the country are looking at this Nurses United campaign because it's going up against a chain of fifteen hospitals, and that's rare."

Challenging a mega-chain like Health Midwest is unusual enough, but what's especially amazing is the sense of community that Nurses United has created in a relatively short time. It's clear from talking to these nurses that this campaign is more than a series of votes in individual hospitals.

People who work in different Health Midwest hospitals in the Kansas City area are comparing notes, getting to know each other--feeling, as many nurses on the campaign express it, "less alone."

DeAnna Edwards says, "We get support everywhere. Every time a [patient who is] a union worker comes into the E.R. and sees me wearing my union ribbon, they say, 'Way to go.'"

As Cheryl Thompson describes it, "People at these hospitals have pulled together. We know we're all in the same fight. We know we're working toward something better, for our patients and our profession."