The nurses at St. Charles Home Health and Hospice in Bend, Oregon, has joined the Oregon Nurses Association (ONA) to negotiate better working conditions, compensation and other issues.
The home health and hospice provider is part of the St. Charles Health System, a non-profit organization serving communities in Central Oregon. The system also operates four hospitals and several family care clinics, with 4,500 caregivers, more than 350 active nursing staff and 250 attending nursing staff.
The drive to unionize began in 2020, according to hospice nurse St. Charles Cherie Iannucci, who helped organize the movement to seek union representation.
The home health and hospice department had undergone a leadership change, and new leadership came in with a different set of priorities, Iannucci said.
“Many of my colleagues left after the new director. She didn’t have the same philosophy or directives for care, and when you work in hospice, you become very passionate about taking care of your patients,” Iannucci told Hospice News. “The idea of hospice is to give comfort to people at the end of their lives and to support them, and that has been taken away from the nurses.”
Nurses became frustrated and their attempts to seek compensation from the health system were not as fruitful, Iannucci pointed out. In addition, they have not received an annual salary increase for at least two years at this point, and their travel reimbursement remains the same despite rising gas prices.
A top priority for St. Charles Home Nursing and Hospice was getting more help to reduce the workload for each staff member. Some nurses had to travel more than 100 miles a day to see 25 or more patients, Iannucci said. Burnout was also becoming more prevalent among their home health and hospice teams.
The St. Charles Health System recognizes the difficulties associated with travel. Much of the Central Oregon area is mountainous and endures cold winters with snow accumulation that can affect roads and driving conditions.
“St. Charles is in an isolated geographic area and we cover many remote and rural communities with home health and hospice care,” Debbie Robinson, director of home care for St. Charles Health System, told Hospice News in an email. “We understand that winter driving conditions can be difficult and we believe in supporting our carers to ensure they can safely reach our patients to provide the care they need.”
After several previous unionization attempts that were unsuccessful, nurse organizers turned to the ONA.
The union represents more than 15,000 nurses across the country in various health care settings, including some who work in other units within the St. Charles Health System and a number of other hospice providers. ONA, founded in 1904, is affiliated with the American Nurses Association (ANA), the American Federation of Teachers (AFT), the AFL-CIO, and the National Federation of Nurses (NFN).
The process of signing with ONA went quickly, according to Iannuci. The nurses received union cards in less than a week after 85% of the 39-nurse team voted to join.
St. Charles has not opposed unionization, according to Robinson, who acknowledged that other nurses employed by the health system are also ONA members.
“While we do not believe it is necessary and would prefer to work directly with our staff on employment matters, St. Charles Health System supports the rights of its employees to organize and be represented by a union,” Robinson said. “St. Charles has a long-standing relationship with ONA. Our teams do their best to work with ONA representatives to resolve issues whenever possible.”
Nurses’ reasons for seeking union membership mirror issues faced by many other health care employers across the country, according to Matt Calcia, ONA’s director of nursing practice and professional development.
“It’s similar to what we’re seeing elsewhere where nurses and other health care workers are looking to unionize. It’s an erosion of working conditions, and a big part of that is that the healthcare industry is constantly asking more of nurses and providing less support, and the pandemic has really, really exacerbated that and accelerated the deterioration of working conditions.”
Unions are relatively rare in the healthcare sector. Among the more than 18,000 health care workers in 2021, about 7.7 percent were unionized, according to the U.S. Bureau of Labor Statistics. This is down from 8.3% in 2020.
However, conditions worsened by the pandemic have the potential to prompt more workers to consider seeking representation, Jon Anderson with Hush Blackwell on the 2020 JD Supra Podcast.
After all, Robinson told Hospice News, with costs and labor shortages exacerbated by the pandemic, “doing more with less is a difficult reality facing the entire healthcare industry.”
“The healthcare industry has been hit hard by the COVID-19 pandemic and its aftershocks. “St. Charles, like most health systems in the country, is doing its best to deal with the high level of demand for services with a significant workforce shortage,” Robinson said. “The cost of providing care has increased dramatically, while reimbursement for services has remained the same. Yet we remain dedicated to our mission as a not-for-profit organization to provide care to all who need us, regardless of their ability to pay. “