Unionized healthcare workers are about as common in Arizona as igloos, but a major shift in labor relations for the state's 92 hospitals could be on the horizon.
On April 2, a critical unionization vote among more than 800 nurses and support workers will be taken at 514-bed St. Joseph's Hospital and Medical Center in Phoenix. St. Joseph's is the state's largest hospital. A unionized work force there could provide a toehold for organizing other facilities.
"We'll establish a local chapter in Phoenix to represent healthcare workers if we're successful at St. Joseph's," said John August, organizing coordinator for the Washington-based International Brotherhood of Teamsters, which is vying for representation at the hospital.
The Teamsters is not the only union looking to establish itself in Arizona. The Chicago-based National Union of Hospital and Health Care Employees is attempting a joint venture with the Communication Workers of America and the Arizona State AFL-CIO to organize the 27,000 healthcare workers in Phoenix, according to recent reports in the Phoenix Business Journal.
Meanwhile, the United Food and Commercial Workers Local 99 is trying to organize the 500 nurses at 227-bed Thunderbird Samaritan Regional Medical Center in Glendale, just west of Phoenix. While a vote hasn't been scheduled, the union has been distributing literature among employees. And like the Teamsters at St. Joseph's, it has been clashing loudly with management about its organizing attempts.
Earlier this month, the UFCW filed a grievance with the National Labor Relations Board, alleging Samaritan Thunderbird's management has prohibited the distribution of materials at the hospital. Officials with Phoenix-based Samaritan Health System, Samaritan Thunderbird's parent firm, said it has a policy prohibiting organizations from soliciting on its property.
Dan Green, Samaritan's vice president of system development, confirmed there are "pockets of organizing activity at Thunderbird," but he said he believes there is little reason for union representation.
Arizona rarely has extended its warm, sunny climate and genial atmosphere to organized labor. As in virtually every other state in the Southwest, Arizona has "right to work" laws, where union representation and the paying of dues is not mandatory for employment. According to the Arizona Hospital and Healthcare Association, only 70 of the state's approximately 55,000 healthcare employees belong to unions. Association President John Rivers said previous efforts to unionize have fallen flat.
"They've usually been pegged to isolated organizations where there has been employee discontent regarding a single event or executive," said Rivers, who added that there has not been an organizing attempt in nearly a decade.
However, Rivers conceded the current efforts have demonstrated more energy than previous attempts: "The attempts at two hospitals at once put it at a greater scale than we have seen before," he said.
Rivers and others agree that the current environment in Arizona is attractive for union infiltration.
"The unions see a very green, fertile field because managed care is coming onto the scene and because there have been a lot of staff reductions and cutbacks," said Robert Zeman, managing partner for the Phoenix office of Littler and Mendelson, a San Francisco-based law firm that specializes in labor issues. Some recent mergers and other dealmaking in the Phoenix area also have stoked the fires, Zeman added.
"You've got organizations merging together, and lines of communication are no longer open, and a lot of uncertainty among employees. All the necessary ingredients are there," he said.
According to the state hospital association, three major layoffs have occurred in the state since January 1997, totaling 420 employees. The largest, involving 250 employees-including about 225 nurses-took place at St. Joseph's. The hospital contends the layoff was much lower, about 70 workers, and most eventually were rehired.
"They made these massive layoffs of longtime nurses under the rubric of restructuring," said the Teamsters' August. "And then to add insult to injury, St. Joseph's has hired all these contract nurses who are not actual employees, people who might get paid more on a per diem basis but receive no benefits."
Some nurses in favor of unionizing say the contract nurses have been assigned to units where they have had little experience or that units have been left short-staffed.
"The hospital is getting a lot more patients with a lot higher acuity being treated by a less professional staff," said Debbie Schiller, who has worked at St. Joseph's as a registered nurse at various times since 1976.
"The nurses hope to gain the ability to have some say on working conditions and what goes on with patient care," said Anne Dusault, a St. Joseph's nurse for five years.
Those on the other side of the issue said the unions have created a rubric of their own: campaigning for increased wages and benefits under the guise of improving patient care-a linchpin of the unions' efforts thus far.
"People would have to be very gullible to believe that. It's a marketing strategy, not a commitment with any breadth or depth to it," Rivers said.
That's why many observers believe that while the unions might score some victories in their latest efforts, they will be unable to make enormous headway in the long term.
"A lot of the hospitals are not well-prepared for this, but they are still positioned very well," Zeman said. "They treat their employees well, and are good with communications. You don't become unionized overnight; it takes years of poor management and miscommunications."