Health & Society
Woefully Understaffed, Maryland Nurses Fight to Unionize
Suzanne Mintz is a nurse at Holy Cross Hospital in Maryland. Since February 2016, she has been organizing with other nurses to form a union.
March 14, 2017
Image: Despite freezing weather, over 150 nurses, community leaders, clergy, elected officials, and activists rallied last month in support of nurses who are organizing at Holy Cross Hospital. Credit: NNU
Recently, the NLRB found 18 unfair labor practice complaints lodged against Holy Cross management to be legitimate. In this interview, Mintz shares her motivations for organizing, the challenges she’s faced, and the dire conditions. She ends by discussing the ongoing attacks on Obamacare and the broader political situation.
What are working conditions like at Holy Cross Hospital and what drove you and other workers to organize for a union?
We’re the second-largest baby hospital in the state, with over 10,000 deliveries per year. I work in the NICU, where there are 120 nurses. We’re a 47-bed, level III NICU, but we are currently operating with up to 52 to 60 babies. We don’t have the staffing to meet that number. Some of the babies require one-to-one attention, but when you’re this overrun, one-to-ones are rare.
I’m a mother and I had a NICU baby. I expect of myself what I expected of the nurses who took care of my baby, but we are woefully understaffed. When the administrators tell us, “Just do the best you can,” that just doesn’t cut it, it’s not what people want to hear from their baby’s nurse.
The union is not a third party. We are the union.
The initial things that drove us were the patient-staff ratios, floating, not having supplies and resources to do our work. We had been fighting—asking our manager, trying to change things, but when we complained, nothing happened. We wanted a union to improve patient safety, working conditions, benefits and wages. But the only way to make that happen is if we have a contract with the hospital. We’re like assembly-line workers: clock in, clock out. We deserve to be treated more professionally because the work we do is so important.
What has organizing at your hospital been like? What challenges have you faced?
We approached National Nurses United and said, “We want to change this. Do you think you can help?” So that began the process. We started in the NICU, with the nurses we knew, then started branching out to other units. We would catch nurses and say, “Hey! We want to talk to you about making things better here,” and go with them to meetings where they could learn more. We were in that process for a long time, until we finally got to the point where we got people to sign cards. The cards are used to file a motion for election with the federal government, the NLRB. They represent a petition by nurses who want to bring this to a vote. The required minimum set by the government is 30 percent of nurses, but you don’t typically file with just 30 percent—you want to have the vast majority so that when election happens, you know you’re going to win. We’ve been collecting cards since June.
A big challenge we’ve faced is Mgmt has hired a union busting firm, who is being paid hundreds of thousands of dollars. When new hires are in orientation before they even hit the floor, they are being made to sign forms against the union, they are being told about how bad a union would be and the benefits of not having a union because “you can talk to your manager.” They’ve come in the door being told, “Watch out for these union nurses, they’re terrible.” Also, they’re not hiring experienced nurses. Instead, they’re mainly hiring young, new nurses—who are taking their first job, are scared to death, or are just grateful to have a job—they’re not going to rock the boat. Unfortunately, they don’t last long because they quickly realize the working conditions are so horrible: it’s like a revolving door.
The union busters have a captive audience—the hospital gives them carte blanche access to the nurses. Charge nurses and managers go to 2-3 meetings per week where they spend hours in what they call the “war room” to talk about union-busting strategies, how to intimidate nurses and stop them from signing cards. There are blatant lies being told by the administration, it’s breathtaking. They tell nurses that people like me—really vocal nurses—are being paid $10,000 to be involved.
We’ve had letters written by Montgomery County council members and state legislators supporting our campaign, affirming that nurses have a right to organize. Two of the legislators contacted the CEO and asked for a meeting, the CEO agreed, but when the legislators said they wanted to bring along some nurses, he changed his mind and refused.
The National Labor Relations Board found our 18 charges for unfair labor practices to be legitimate, for their harassment, surveillance, and intimidation. The hospital was rattled, but nothing really happened. They don’t get fined; they don’t have to do anything. The hospital of course said they were going to appeal the decision in May; they are trying to intimidate us by saying they would force us to go to trial.
A lot of resources are being spent on union busting. Why are they fighting so hard to stop nurses from forming a union?
That’s the question we ask all the time. We are asking for a voice, a contract, to improve patient care and to improve patient conditions. What’s wrong with that? Why would they fight so hard for that? It’s about the money. We are one of 90 hospitals owned by Trinity Health out of Michigan.
What’s happening with Holy Cross is really happening all across the country: the big organization is eating up all the small community hospitals. In doing so, they are trying to centralize and slim down on every expense. At the same time, they’re making bundles of money. As a non-profit hospital, the money is supposed to be reinvested into the hospital, but instead, the money is going into appalling bonuses for senior administrators. Even when they wouldn’t give us a raise or add more staff, when they were cutting our benefits, their pockets were getting deeper—all at the expense of the patients.
The hospital is pushing back because they are used to dictating. They say, “This is a hierarchy. You’re a pawn, and you can’t talk back. If you talk back, you’re out of here.” We’re saying, “Enough of that. We are the ones doing the work. We are the bread and butter of the hospital. We should have a say in how it’s used.”
One of the ways it should be used is to increase patient safety by adding more nurses, proper supplies, but also by increasing our pay and benefits so nurses stay. If your salary is not commensurate at all with your workload—when you’re taking care of so many patients, you’re not going to stay. It’s important to keep the seniority, so good nurses with experience will actually stay. People are not happy, so they leave. Every time they have these turnovers, they are throwing money away.
How have you stayed motivated all these months? How have you personally withstood the attacks?
It’s been an up-and-down emotional roller coaster. One of the things that kept me going is that we’ve already seen what collective action can do. In the NICU, three of our nurses who were supposed to precept. But because they were pro-union, they were told they were not going to precept. We all got wind of it, got angry. And agreed that if these three can’t precept, none of us would. Senior director of the division made a personal appeal to each preceptor, pleading for us to continue precepting. That was huge. Did we buy her sincerity? Absolutely not. But we showed ourselves that when we stand up for ourselves, everyone benefits.
If we don’t have a contract, any of the things that we act to change won’t stay in place. They’re responding to our collective action now and hope they will appease us. But we know that if we abandon this fight before coming to election, everything will go back to what it was. Because there will be no contract. I keep reminding myself that there are victories in this, and it’s the right thing.
Every time the administration does something horrific, it just strengthens my resolve. I couldn’t sleep at night if I didn’t continue this fight. I don’t understand how they sleep, knowing the lies they tell and the way they treat nurses. That’s what keeps me going.
With Trump in power, Republicans are pushing to repeal-and-replace the Affordable Care Act. Their proposals include major tax cuts, one of which would deliver an estimated $157 billion to people who make $1 million or more over the next ten years. They want to eliminate the federal individual and employer mandates, cap federal funding for Medicaid, and raise the amount that insurance companies can charge the elderly (from 3 times to 5 times that of younger enrollees). What do you make of this?
Well, the ACA was necessary. It wasn’t perfect, but it ensured healthcare coverage for many people who didn’t have it before. It’s better for hospitals—if we stick with the hospital theme—they’re getting money from the ACA, so it’s a good thing for hospitals Also, for people whose lives are dependent on coverage to live or have a good life.
It’s unconscionable—the message it sends to me is that if you’re poor you don’t deserve to have healthcare, and if you can afford it, go for it. They frame it as some kind of choice, a decision people should be free to make, but when you don’t have two nickels to rub together, there is no “decision.” When you have no option to actually have health care, you’re going to miss out, you’re going to be sicker. We’ll see these changes reflected in emergency rooms; in taxes; reflected in the condition of people living on the street. We’ll see it in children, their ability to go to school.
Fundamentally, we all deserve to have health care. It should be a basic human right. This particular administration frightens me because they have no regard for what it means to live day to day and try to get through the day. Their privileges have shielded them from the reality of what most people are going through. And it breaks my heart.
There’s also a national right-to-work bill in being cooked up by the GOP, and likely to emerge soon. Many states have already been transformed by right-to-work. What do you expect will happen for workers in your area, and how do you think it would affect the organizing and conditions of people like you and other nurses at Holy Cross?
I think it’ll have a tremendous impact. My understanding of right-to-work is that it’s being led by people like Brent Yessin—the millionaire union-buster that the hospital hired to bust us up. I have a friend whose husband is a firefighter in Virginia, a right-to-work state. He says they’re in a union, but they can’t do much.
My understanding is that with right-to-work legislation—for example, nurses who are unionized—it doesn’t demand that every nurse be a member of the union. What would be the incentive for a nurse to pay dues, if she thinks she/he can benefit off the backs of other nurses who are paying dues? It becomes a disincentive for people who want to be part of the union, it dismantles the unified voice of nurses: you have some who are for the union, and some who aren’t. You don’t have the bargaining power and your contract will be affected.
Once Trump appoints his head of the NLRB, you can be sure that cases like the ones we presented will get shot down. That’s extraordinarily frightening. We will really be at a disadvantage. It’ll get worse for any worker who has a claim against any employer.
Do you have any last thoughts you’d like to share?
In doing this, what I’ve come to realize is that there are people who simply don’t have a voice. For those of us who are able to and have the strength to--- it’s our responsibility to reach out to our fellow workers – wherever that work is—and support them, encourage them, and try to get them involved in this fight. I hate that this is a “fight” because it shouldn’t be a fight. It’s a right. I just want them to be more involved, and more engaged in our right to be heard. To have appropriate working conditions.
We are doing this for our patients, and our patients range from the poorest of the poor to the wealthiest of the wealthy. Everyone deserves the highest quality of healthcare, bur in my view, we are not providing that. There’s that special patient who gets the privileges and the attention, but not your average Jill who walks in the door and needs to be cared for. That’s painful to watch.
My patient advocacy role (along with my nursing skills) is one of the most critical mandates I have as a nurse. But I can’t advocate for my patients if the administrators won’t listen to me. The only way I can advocate is if I can bring my voice to the table along with my fellow nurses and share in a way they are legally required to hear. To honor that, I can’t sit back and let the hospital ignore what’s happening. Bringing more nurses on board and giving them the support they need so that they can advocate for their patients—that’s what keeps me going.
Interviewed by Tre Kwon