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UW Health nurses push for union amid health care system strain

UW Health nurses union action

On Thursday morning, a group of nurses met with UW Health CEO Dr. Alan Kaplan and made their case for voluntary recognition of a union.

UW Health nurses were sounding the alarm on working conditions before COVID-19 strained the health care system to the brink.

Cost-cutting measures implemented over the last five years have left them concerned about understaffing, overwhelming patient loads and high turnover rates — things they argue have a negative effect not only on nurses and hospital employees, but on patients, too. At their worst, they say, the changes create unsafe situations. And they say the COVID pandemic has elevated the problem to a crisis level.

Many nurses say a union is needed to address these challenges. UW Health administrators acknowledge there’s a problem — but they argue the 2011 state law known as Act 10 prevents unionization from being the answer.

Since 2019, nurses at UW Health have sought to form a union, with help from SEIU Healthcare Wisconsin. On Thursday morning, a group of nurses met with UW Health CEO Dr. Alan Kaplan and presented more than 1,500 cards signed by nurses showing their support for unionization.

A UW Health spokeswoman, Emily Kumlien, acknowledged that the meeting took place, but noted the nurses did not leave any signature cards with administrators, “so we do not know how many of those signatures may be from our 3,400 RNs at UW Health.”

Nurses involved in the unionization effort argue the 3,400 figure is misleading as it includes nurse managers and nurse practitioners, who would not be included in the union. They say the number of union-eligible nurses is 2,600.

Kumlien pointed to a letter sent by Kaplan to UW Health employees last month, in which he pledged to address “our challenges as a team with a commitment to significant and open communications.”

“Our job is to advocate for our patients, and the way we see that we can do that is to restore what UW used to be. We want to partner, we want to work with the (University of Wisconsin Hospitals and Clinics Authority) Board so we can provide the best care possible,” said Delia Pertzborn, who has worked for UW Health since she was in nursing school in 2014. “We don’t want to fight them; we want to work with them. But we really need our own voice to do so. We can’t rely on the good will of administration.”

UW Health is not alone in this challenge. A 2021 report from the American Nursing Association found that 1.1 million new RNs would be needed to avoid a nursing shortage in the U.S.

In addition, reporting from 2020 showed that nearly 70% of hospitals throughout the country had implemented business models inspired by manufacturing companies to boost efficiency and reduce labor costs. Since 2017, UW Health has been on such a path.

Kelly O’Connor, a UW Health pediatric nurse, said the staffing model changes implemented prior to the pandemic made her feel “like I couldn’t give my best quality care that these kids deserve.” O’Connor has been a nurse at UW Health for seven years.

Every floor was affected differently, O’Connor said, adding that she was expected to take on higher-acuity patients (in other words, patients with high-risk conditions who require more attentive care) and one additional child per shift without any additional resources. She often feels like she doesn’t “physically have enough hours in the day” to get the work done.

Pertzborn, who specializes in bone marrow transplants and hematology, oncology and palliative care, said her unit has lost 18 nurses since June.

“We are hemorrhaging experienced staff in a way I’ve never seen before, and it is alarming. I can’t even describe how concerned I am about what we’re going to look like in a few months,” she said.

Where do they go? For some nurses, Pertzborn said, moving to an outpatient clinic — where the pay can be comparable to that of a new hospital hire — is an attractive move. Others might move to another institution where they can get a substantial signing bonus. And still others are leaving the profession entirely, some with diagnoses of post-traumatic stress disorder, she said.

“If you’re short-staffed, the patients are still there,” Pertzborn said. “So what do you do? You take on more responsibility and a (larger patient load). When that load is people’s lives, mistakes get made. People don’t get the top level of care that they deserve. … We are having to triage what is the most important thing to do for people.”

In his letter to UW Health employees last month, Kaplan acknowledged that “the personal toll (of the work) has been and continues to be high.”

In addition to responding to the pandemic, Kaplan wrote, UW Health leadership has been focused on responding to workforce challenges including staffing shortages, stress and wellbeing and work flexibility.

“This work can be difficult and stressful in the best of times. And we all know these are not the best of times. We are managing a surging pandemic with record patient volumes, all in the face of a national staffing shortage the effects of which we feel very acutely throughout our entire health system,” Kaplan wrote. “All of us recognize the great dedication and talent within our ranks and our need to care for the people who care for our patients.”

Earlier this month, more than 400 UW Health nurses spoke with Gov. Tony Evers in an online forum. Evers followed the meeting with a statement in support of their unionization efforts.

“I firmly believe that nurses can advocate most effectively for themselves and their patients when they have a union voice and have actual power in the decision-making process while also having the opportunity to hold management accountable around urgent issues such as safe staffing, health benefits, continuing education, and recruitment and retention of nurses,” Evers said.

UW Health administrators argue their hands are tied by Act 10, the 2011 law signed by Republican former Gov. Scott Walker effectively eliminating collective bargaining rights for most public employees. 

In his letter to employees, Kaplan cited several legal opinions in his conclusion that “no further action can be taken until current state laws are changed.”

“We recognize and appreciate that this reality is very difficult for some employees. We hope that their clear passion can be redirected toward the state legislature, which is the most appropriate venue for this debate. At the same time, I am asking and hoping that those passionate about a nurse union fully commit to our team efforts,” he wrote.

But nurses pushing for unionization point to another memo, prepared at the request of state Sen. Melissa Agard, D-Madison, in October of last year. 

The nonpartisan Wisconsin Legislative Council concluded that, under Act 10, although the UW Hospitals and Clinics Authority has no legal duty to recognize an employee union, it may voluntarily acknowledge such an organization. In that case, UWHCA could allow the union to participate in discussions on wages, hours and working conditions.

“I don’t want to leave,” Pertzborn said. “I love UW. I know what it can be at its height. I used to be so proud to work there, and I really want to be proud to work there again. And I think a union voice isn’t going to be a magic wand and fix everything overnight, but I think it’s the first step to getting back on track to providing the very best patient care in the area.”

This story has been updated to include a statement from nurses regarding the number of employees eligible for a nurses' union.

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