1,800 nurses at Mission Hospital in Asheville, North Carolina voted for unionization this week after months of deliberation and intimidation from their employers. National Nurses United, the largest organization of registered nurses in the U.S. with over 185,000 members across the country, will now represent the group. This marks one of the largest victories for organized labor in the history of the South.
The facility is owned by HCA Healthcare, based in Tennessee, the largest hospital corporation in the country. The company used a range of intimidation tactics to encourage nurses to vote no, but these providers stood up for their right to organize and fight for better working conditions.
The Long Road to Unionization
The nurses at Mission Hospital filed to hold an election to unionize back in March. About 70% of RNs signed union authorization cards to join National Nurses United, which already represents nurses at 19 HCA Healthcare facilities.
Normally, the vote would come just a few weeks after the request had been filed, but recent changes to the state’s election laws pushed the date back months. HCA Healthcare quickly appealed to the National Labor Relations Board, which is responsible for enforcing labor laws across the country, to postpone the unionization election due to the coronavirus. However, critics have accused the organization of undermining organized labor under the Trump Administration.
The nurses at Mission Hospital say working conditions have worsened under HCA Healthcare and that the company is hindering their response to the pandemic. The for-profit corporation acquired the nonprofit facility in February 2019 for $1.5 billion.
Postponing the vote to September gave HCA Healthcare months to intimidate staff members into voting against unionization, even as the number of positive COVID-19 cases in the state rose.
The corporation demanded that nurses leave their shifts to meet one-on-one with consultants from the Crossroads Group. Nurse Jill Rabideau told a local news outlet that she was pulled away from her patients to join a group of her colleagues for a “Labor Relations” session led by an anti-union consultant on March 15th.
“It was an hour and 15 minutes of listening to an angry little man in a room that probably had 15 other nurses that were pulled off their units,” Rabideau said. “That was very frustrating to me, but particularly when everybody had all these Covid questions.”
Sarah Kuhl, a registered nurse at the facility’s oncology research department, says these “sessions” were misleading. “A lot of things we heard is that you won’t be able to talk to your manager anymore. We heard you won’t get wage increases until the contract is signed, which is not true.”
Reports from the Department of Labor show that these union-busting consultants were paid $400 an hour. The group has issued similar messages to employees across the country. In 2003, the firm’s founder, Michael Penn, violated federal labor law when he threatened that employees would lose their benefits at Jensen Enterprises if they voted for a union. He violated these laws again in 2010 when he threatened to sue a pro-union employee at DHL for “defamation.”
Nurses say the company reduced nurse-patient staffing ratios and limited their access to PPE at the height of the coronavirus.
“They were just demanding that we cover nurses on their assignment, even though it’s inappropriate because we just couldn’t afford to let staff go at that time,” emergency room nurse Trish Stevenson said at the time. “We’re already in a state of red and then we’re being faced with a pandemic that is just further going to compromise us. My worry is we just won’t be able to respond at all to the pandemic.”
A History of Abuse
Over the course of the pandemic, HCA Healthcare has collected $4.7 billion in benefits from the CARES Act, including those from direct payments to hospitals, accelerated Medicare payments, payroll tax deferrals, and other benefits.
CEO Sam Hazen earns $27 million annually, 478 times the median HCA employee, and the company paid out over $600 million in dividends to shareholders last year, according to reporting from The Intercept. In 2000, the corporation pleaded guilty in the case of the largest Medicare fraud in U.S. history and paid $1.7 billion in fines. Current U.S. Senator Rick Scott, R-Fla., was CEO at the time.
A Win for Organized Labor
Finally, Mission’s nurses got to cast their vote for unionization. In a landslide victory, 965 to 411, they voted to join National Nurses United. The group will now begin negotiations over a contract with HCA Healthcare.
NNU and NNOC Executive Director Bonnie Castillo, RN was thrilled with the news. As she said in a statement:
“We could not be more proud of the unity, the perseverance, and the patient advocacy and dedication of the Mission RNs to their patients, their colleagues, and their community. At a time when nurses are in a daily battle with the deadly fight for their patients and their own lives in the era of COVID-19, they have demonstrated incomparable courage and resilience that is an inspiration to all of us.”
This gives the nurses at Mission the power to decide their future as they continue working under HCA Healthcare. Lesley Bruce, a nurse who works in chest pain observation at Mission, said, “This victory means we can use our collective voice to advocate for patient safety and safer staffing. I can’t wait to see what improvement we’ll win together.”
Nurses around the country continue to advocate for their right to organize. The last large victory for nurses was in 2018 when 2,200 nurses at Albany Medical Center in Albany, New York voted to join the New York State Nurses Association. We all need to watch out for one another in the workplace and use our voice to advocate for fair working conditions.