On January 29, the registered nurses of MercyOne Siouxland Medical Center in Sioux City, Iowa, ratified a three-year contract with the hospital after a seven-month fight. It’s a contract they are calling “the best in the history of their negotiations with the employer,” and it represents an important symbolic victory in the year of Florence Nightingale's 200th birthday, which has been designated “Year of The Nurse and Midwife” by the World Health Assembly.
More than 300 MercyOne nurses are represented by the United Food and Commercial Workers (UFCW) Local 222, which is roughly 70 percent of the hospital’s nursing staff. When contract negotiations started last June, the union nurses sought competitive pay, protection of medical benefits, and lower patient-to-nurse ratios to remedy the “understaffing crisis” at the hospital.
[Nurses] encounter numerous occupational hazards in the field, such as workplace violence, exposure to dangerous chemicals, and physical injuries.
“There’s a nursing shortage,” says MercyOne nurse Jennifer Beacom, a member of the bargaining team. “I feel that staff and patient safety go hand in hand, and that was the main issue for us.”
Nursing is one of the nation’s fastest-growing professions, with nearly three million registered nurses nationwide, a number that is projected to keep rising into the future. The health care and social assistance industry is the largest employer in the state of Iowa. According to a 2019 Workforce Development report, there were more than 224,000 employees statewide in 2018, and this sector is projected to net more than 5,490 additional jobs from 2018-2020.
A 2019 survey of nearly 20,000 registered nurses in the United States, conducted by AMA Healthcare, found that two-thirds of nurses interviewed worry about how the mounting pressures demanded of the job can affect their mental health. Adding to the stress, they encounter numerous occupational hazards in the field, such as workplace violence, exposure to dangerous chemicals, and physical injuries.
The MercyOne nurses had previously rejected hospital management's “best and final offer” and voted overwhelmingly to authorize an unfair labor practice strike on January 13. The union released a statement after the vote, alleging intimidation by hospital administration:
“In violation of the National Labor Relations Act, MercyOne has unlawfully intimidated, coerced, and disciplined our hard-working nurses for sticking up for themselves and for supporting their Union and each other during the course of this contract dispute.”
MercyOne Siouxland provides services for a thirty-three-county area stretching across western Iowa, eastern Nebraska, and southeastern South Dakota. The hospital’s website says its mission is to provide “extraordinary care for patients in the communities it serves.” Based on what transpired in the months before settling on a tentative agreement, the nurses say the hospital was not living up to this promise.
During some of the early bargaining sessions between UFCW 222 and the hospital, MercyOne representatives showed up late to some of the sessions and even left early, according to ER/Trauma nurse and UFCW member Alyssa Rusch.
“I think the most difficult hurdle was getting the point across to leadership that we were serious about what we were asking for,” Rusch says.
For several months, UFCW 222 circulated petitions, organized community rallies, and hosted a candlelight vigil. Union members and allies stayed connected with these issues, and each other, through a Facebook page dedicated to the MercyOne nurses, UFCW 222/MercyOne RNs for a #FairContract, which has more than 2,100 followers.
“We had conversations with nurses at other hospitals on how to form a union and what the process is,” Beacom says. “I think they listen to us and watch what we’re doing and it has a strong impact across the country, even locally.”
On November 21, MercyOne nurses rallied union members and supporters at the Holiday Inn located on Gordon Drive. Hundreds of people packed the conference room, and the event was live-streamed on Facebook. Those in attendance and watching online were urged to text the message “support222” to phone number 83071 and sign the petition.
That evening, Beacom addressed the obstacles during negotiations: “We have spent multiple hours preparing proposals that we felt would benefit both the hospital and the nursing staff, only to have the hospital show up with empty-handed half-proposals, takeaways, redlines through all of our proposals that we spent many hours working on.”
A dramatic instance of management hostility occurred on the morning of January 9, as another round of negotiations was underway, nurses say. Beacom and nurse Ashly Fiedler, who is also a union steward, went back to the hospital to share updates with the nurses and hand out solidarity bracelets.
“When senior management found out we were there,” Beacom says, “they told us to leave, saying we couldn’t do union business at the hospital.” She argues that such activities fall under the protection of federal labor laws.
Fiedler’s husband, Derrick, posted about the incident on Facebook: “This is just another example, among a litany of such evidence, of the toxic management culture at MercyOne, where they foster antagonism between management and staff, where staff are seen as the primary liability to the organization rather than their greatest asset, where nurses do ‘nickel work’ and management treats them as an inferior class.”
MercyOne Siouxland President Beth Hughes expressed her dismay with the nurses’ prior vote authorizing a strike in an email sent out that evening, calling the MercyOne offer “excellent” and claiming that “only 52 percent of our nurses were eligible to vote because they pay union dues.”
Hughes’s email, which the union said was plagued with inaccuracies, was seen as a way to intimidate the nurses into backing down. UFCW 222 issued a response letter, claiming Hughes deliberately misrepresented the number of nurses who are union members to undermine the union’s strength as their bargaining representative.
“This bad-faith bargaining is unlawful under the National Labor Relations Act,” states the letter from UFCW 222 trustee Leticia Ramirez. “The Hospital’s implications that the Union does not represent all registered nurses in bargaining is a separate Unfair Labor Practice.”
Asked about these tensions in the aftermath of the new contract, Beacom says the union and MercyOne have already moved on and are concentrating on working as a team in the future.
“That’s in the past,” Beacon says. “We’re now forming a good relationship and I don’t think dwelling on past instances is going to help our relationship.”
Once the strike authorization vote was finalized and nurses prepared for the strike, MercyOne agreed to renegotiate with the union. Strike training sessions at Holiday Inn, three scheduled in total, were cancelled when the UFCW 222 bargaining team announced it had reached a tentative agreement with the hospital on January 23.
Rusch says the vote ratifying the new contract is a “victory for the entire Siouxland community and sends a strong message about the power of workers standing together.”
“We had a strike training class that morning,” Beacom says. “When we reached a tentative agreement that we thought we could vote on, we went into the other strike class and cancelled the last one. There was a lot of crying, applause and excitement.”
The new contract, ratified with 97 percent of the vote by UFCW 222 members, includes:
- Changes to address understaffing, including an enforceable safe staffing advisory committee
- Continued access to affordable and quality healthcare for the nurses and their families
- Wage increases and retroactive pay bonuses
- Fair scheduling so nurses are not mandated to take on extra shifts along with their normally scheduled hours
- Improvements to workplace safety protections
Rusch says the vote ratifying the new contract is a “victory for the entire Siouxland community and sends a strong message about the power of workers standing together.”
The contract ratification was not just a victory for the MercyOne nurses, but a victory in the national struggle of nurses and hospital workers fighting for their rights and for patient safety in the health care industry, showing that union solidarity can prevail even in a right-to-work state like Iowa and beyond.
“We won a small battle, but there is a much larger war to be won,” Rusch says. “Nurses on a national scale need to come together to make a permanent change to staffing issues. I really hope that our union, and other unions going to bat for the same issues, have inspired other nurses and organizations to advocate for themselves, whether they are union or not.”
