Promotional materials for UnityPoint Health—a nonprofit health care provider which operates hospitals, clinics, and home care facilities across Iowa, Illinois, and Wisconsin—prominently feature the company motto “You Matter.” But when UnityPoint nurses in Des Moines, Iowa, marched across the city’s downtown to Methodist Hospital on June 8, the signs they carried told a different story: “Put Patients Over Profits,” and “Stop the Delay, Certify Today.”
In December 2025, nurses at UnityPoint Health-Des Moines voted 871 to 666 in favor of unionizing with Teamster Local 90 as the United Nurses of Iowa. But seven months later, executives at UnityPoint are refusing to certify the election, which would impact four of its affiliated hospitals in Des Moines.
For more than two years, UnityPoint nurses have been organizing for better pay, better health care coverage, consistent scheduling, and safer staffing practices. Whitney Armstrong, a registered nurse and United Nurses of Iowa organizer, tells The Progressive that UnityPoint’s aggressive attempts to sink the National Labor Relations Board (NLRB) election are being conducted in bad faith.
“Our certification is being held up because [UnityPoint] submitted to the NLRB twelve baseless objections to the election itself,” Armstrong says.
According to Armstrong, UnityPoint told the NLRB that it did not have the authority to certify the election. UnityPoint has also accused the NLRB of mishandling the elections and United Nurses of Iowa of misusing the NLRB’s challenged-ballot procedures to tip the election in their favor unfairly. Because the objections brought claims of bias against the NLRB agents conducting the election, Armstrong says, the NLRB regional board initially tasked with handling the election found itself in an “awkward position,” and has since transferred the misconduct investigations to a different regional board.
UnityPoint nurses say the company’s allegations against the union and the NLRB are baseless. As Armstrong points out, UnityPoint is represented by attorneys from Littler Mendelson, a law firm known for its union-busting tactics. “The company is relying on it being difficult to conduct an investigation,” says Armstrong. “If they stall the certification, they believe we will give up and not continue our fight. If anything, it just makes us fight harder.”
At the time that UnityPoint nurses began organizing in November 2024, many were struggling with what they describe as low pay and deteriorating workplace conditions. Debra Hennings, who has served as a nurse in the adult Critical Care Unit at Methodist Hospital for twenty years, tells The Progressive that since Iowa Health Systems became UnityPoint in 2013, the system “has gotten bigger, more corporate, less like a family.” Hennings has been involved in the union’s organizing committee since early in the unionization effort, and has since become a member of United Nurses of Iowa’s Contract Action Team. She says she became involved in the union with encouragement from her daughter.
“She actually encouraged me to join the union efforts back in 2024,” Hennings says. “I was pretty hesitant at first because of stories I’ve heard about unions over the years. But then I realized that UnityPoint wasn’t going to listen to our concerns without a union behind us.”
Laura Downey, a registered nurse of more than thirty-three years who currently works in the geropsychiatric unit at Iowa Lutheran Hospital, cites inadequate health care coverage as a core concern that drove her to get involved with the union. “The insurance [at UnityPoint] is horrible,” Downey says. “I had surgery last week and am responsible for a $2,500 deductible for an outpatient procedure. I have never had such horrible insurance working for an organization.” She says she’s also seen her peers written up by management for actions that weren’t properly investigated and describes UnityPoint’s approach as “very punitive.”
Downey became involved with the union after she says she was made to sit through a presentation by a company representative intended to discourage employees from joining the union. “It was a person basically saying how horrible the union is and a bunch of misinformation regarding unions,” she says. Presentations such as these—known as “captive audience meetings,” in which workers are discouraged from supporting union representation on company time and property, in a meeting required of them by management—are prohibited by the NLRB, and illegal in several U.S. states.
Armstrong says UnityPoint has been aggressive in its union-busting tactics, claiming that long-serving nurses have been written up for the first time in their careers for supporting the union. “Regardless of whatever steps employees take,” she says, “management escalates the write-ups, forcing nurses to choose whether they want to resign or be fired.”
United Nurses of Iowa
United Nurses of Iowa rally, June 2026.
The union also alleges that UnityPoint has given incentive pay to security staff to watch for Teamsters representatives at hospital entrances, engaged in employee email surveillance, taken down bulletin boards to prevent union materials from being posted, and granted its hired representatives access to break rooms and patient care areas. “Their hired union busters were trolling patient care areas in the middle of the night looking to union bust,” says Armstrong. “Meanwhile, a Teamsters representative shows up during public visiting hours in non-patient care areas and [are] threatened with trespassing [charges].”
As of 2021, Iowa ranked forty-eighth among all U.S. states plus Washington, D.C. and Puerto Rico for nursing wages. Now, nurses in an industry without much financial cushion worry about their job security as a result of UnityPoint’s tactics. The company recently began outsourcing labor to the travel nursing agency AMN Healthcare, which Armstrong describes as akin to a temp agency; these workers, she says, are housed in substandard conditions, significantly underpaid, and lack any meaningful recourse in the event of unfair labor practices.
“I do have fears,” Downey says. “[We were] told at a meeting this week they are working with agencies to bring 110 international nurses . . . . Now we have no recourse if they fire us. With a union, we would have protection, and it would be a process.”
Iowa currently ranks second in the nation for cancer prevalence, with increased risks for farmers in rural areas. According to the Iowa Cancer Registry’s 2026 “Cancer in Iowa” report, there are more than 175,000 cancer survivors in the Hawkeye State; an estimated 21,700 Iowans will be diagnosed with the disease this year, and 6,400 will die from it.
“The reality right now is that patients are sicker than they have ever been, and medicine is the best it has ever been at keeping people alive,” Armstrong says. “Nurses and doctors are good at what they do, but the increasing acuity needs to come with increased staff to help manage it, or staff will start to fail. They won’t fail because they lack stamina, resilience, or expertise; they will fail as a sheer matter of numbers. There is only so much time in the day, in the hour.”
But despite growing fears for their job security, United Nurses of Iowa is still fighting for its right to have its election results recognized. On June 9, the union launched a Change.org petition calling on UnityPoint executives to certify the results of the 2025 union vote to begin the collective bargaining process.
“Nurses spoke in our election, and the hospital is refusing to listen,” Armstrong says. “Nurses are fighters, and we aren’t going anywhere.”