The Oregon Nurses Association added three new bargaining units within the Providence Health System this spring. The elections added 215 new members, including registered nurses, physical therapists, social workers, doctors and nurse practitioners. Providence is one of the largest health systems in the U.S., and it is the state's largest healthcare provider and one of its largest companies.
On April 14, clinicians working for Providence Home Health, Hospice and Palliative Care voted to form a union and be represented by ONA. The group consists of physical therapists, occupational therapists, speech language pathologists, social workers, and counselors. These clinicians are now part of the existing ONA nurse bargaining unit at the home health, hospice and palliative care facility. The nurses in this unit have been at the bargaining table since fall 2022 and have been working under an expired contract since Dec. 31, 2022.
“It seems that profits and organizational growth are being prioritized over quality patient care,” says Kellie Holloway Franz, a home health physical therapist who has been with Providence for eight years. “We’re expected to provide superior care, be more productive, and see more patients while doing more tasks with less time,” she says. “It’s been tough to stay in it and keep our chins up. We’ve lost some excellent clinicians, and we’ve lost some morale.”
Because the providers frequently visit patients in their homes rather than in an office environment, according to Holloway Franz, organizing took time. “It took some work to organize. We aren’t often in the office together; we provide home health and hospice services in the community,” she says. “We conducted most of the organizing via texts and phone calls because we are all like ships passing in the night. Since everyone was under pressure from the higher expectations, getting people on board was easy.”
Holloway Franz says the providers are looking forward to having a place at the table and using a collective voice so that decisions are not one-sided. “There are a lot of us, and we are motivated; that’s why our organizing efforts caught on like wildfire,” she says. “I stay because I love my co-workers, feel valued by my managers here in Portland, and like my commute. Before COVID, we used to gather in person; but since unionizing, I’ve never felt more connected or invested in staying. I want to make Providence a better place to work, and it's been wonderful to know that other people feel the same way.”
On April 18, Providence Women’s Clinic providers voted to join the ONA. There are six clinics located in the Portland metro area. They are well-known for providing outstanding personalized healthcare to thousands of women and families during all of life’s stages. The group is split into two units, one representing physicians, nurse practitioners and certified nurse midwives; the other represents RNs. Both units voted in favor of unionizing.
Jessica Newgard, a nurse midwife, has worked at the women’s clinic for more than three years. The Southwest Portland native says she was drawn to working at Providence because of its focus on midwifery care. When a new midwife joined the team, she called attention to far fewer workplace protections than that of inpatient nurses. The new hire was a former ONA member who was aware of the power of a union. At that point, Newgard began to consider unionizing.
Newgard says the providers often worked past their planned shifts, and the clinics were frequently understaffed. In addition, Providence got rid of the clinic doula program and group prenatal care. Even as their roles were changing, Providence said things were going to get better, and Newgard believed them, but she says her job is very different from what it was when she started. The system has expanded, merged and grown significantly. With that growth, the focus has shifted to how to maximize profit.
Now that the providers are unionized, Newgard wants to focus on protecting the role of midwives so that they can provide continuity of care for patients. “I'm hopeful we can shift the focus to improving patient care,” she says. “Better working conditions for providers would allow us to come to work to provide our patients better treatment.”
Jazmyne Hutchinson, a registered nurse who has worked at the women’s clinic for nearly five years, agrees. “When we all got together during the organizing process, we realized that we have the same concerns.” Hutchinson has seen providers leave over the last several years because they are overworked and underappreciated. Now that they are unionized, she says she feels empowered. “I now have a voice. I am excited to work with Providence to help all of us [providers] feel respected, valued and appreciated. When we have that, we’ll be able to provide the best patient care.”
On April 25, the emergency department physicians, physician assistants and nurse practitioners who work for Providence Medford voted in favor of unionizing. The healthcare providers, now known as the Southern Oregon Providers Association, will be part of the Pacific Northwest Hospital Medicine Association, an existing hospitalists’ union represented by the AFT and serviced by the ONA.
Providence Medford is the first hospital where Dr. David Levin worked after residency, and he’s been there for 12 years. Patient safety issues led him to believe that unionizing was the best way to deal with the problem. “A lot of unions form over benefits and pay,” he says. “That wasn’t the impetus for us to move forward. We want the resources to safely treat our patients.”
Additionally, the hospital has lost specialty services that it had for many years, including gastroenterology, oncology and hematology. Patients are seen by a variety of providers, or they are forced to go somewhere else for specialty care, says Levin. The emergency physicians have also been asked repeatedly to fill roles outside of their department, such as for procedural backup in the intensive care unit, despite being overwhelmed by patient volumes in their own department.
Levin acknowledges that these issues are not unique to his hospital, but his goal is to try and make a change: “It feels good to be doing something rather than complaining or sitting around. It's good to be taking positive steps to effect change.”
“This is an exciting and invigorating time for unions,” says Tamie Cline, an RN and president of ONA. “Healthcare workers in Oregon are tired of not being respected or listened to by Providence management. We welcome these new groups into ONA and know that, by joining forces, we can do a better job of caring for patients and our healthcare colleagues.”
These groups of professionals are part of a wave of healthcare workers unionizing across the country and throughout Oregon. In early April, more than 300 nurses with Legacy Mount Hood Medical Center in Gresham voted in favor of ONA union representation. Nearly 700 health professionals have been organized in the state this year, and more are expected to join soon.