LEBANON — As staffing shortages and extended wait times continue to hamper operations at Dartmouth Hitchcock Medical Center, nurses are attempting to unionize.

Last weekend, pro-union fliers were distributed around DHMC, the flagship academic medical center for the Dartmouth Health system. Nurses were also invited to a pair of meetings in support of unionizing earlier this week at the Courtyard Marriott in Lebanon, according to a post by the Instagram account @dhmc_memes.

Liz Joseph, a nurse in DHMC’s Birthing Pavilion for 21 years, said the recent interest in unionizing is a product of what many nurses view as a weakening “say” for the 2,500 nurses who work at DHMC and its clinics in southern New Hampshire.

“I’m proud to care for our community, and I work with a great manager and team of supportive supervisors,” Joseph wrote in an email to the Valley News. “However, over the years, nurses have been asked to do more and more with fewer staff and even fewer resources.

“Our patients deserve better than the care we are providing and our nurses deserve to truly feel appreciated. We are collectively coming together to have an equal seat at the table with administration, and we’re looking forward to implementing lasting improvements to patient care in a safe environment.”

After DH executives caught wind of the unionization effort, they responded with a message of their own to nurses earlier this week.

“In my view, a union does not offer the best path to change,” Chief Nursing Officer Tracy Galvin wrote in an email to staff on Monday. “I say that because I’ve seen the conflict and division some nursing unions create. I’ve seen nurses pitted against each other under union contracts that reward seniority over performance, or limit the flexibility that today allows nurses to have a say in their scheduling, care model, and nursing practice.”

Galvin urged nurses to learn more about what being part of a union might mean before they sign petitions or cards authorizing a union to represent them.

“You may decide you don’t want or need someone to speak for you,” she wrote.

DHMC “respects the legal right of our nurses to decide whether or not they want union representation,” Galvin wrote in a statement to the Valley News.

“We have long believed that a union is not necessary and could be counter-productive to the kind of two-way dialogue that is so much a part of our culture at DHMC,” Galvin added. “This open and collaborative dialogue is vital to our role as an academic health system that promotes education, research, outstanding patient care, and positive employer-employee relations to ensure high-quality patient care and service.”

On Friday, CEO Joanne Conroy weighed in with an email to her DH “colleagues.” Conroy wrote, “Personally, I believe strongly that a nurses union at Dartmouth Hitchcock Medical Center is unnecessary and counter-productive. It can often result in an ‘us vs. them’ mentality. I believe the best environment in which to work and provide care is one built on open communication, where we work collaboratively on best practices and address challenges and barriers as they arise.”

For years, organizing activity, or at least rumors of it, have cropped up off and on at DH, New Hampshire’s largest private employer with 10,000 workers.

In 2008, organizers from the Massachusetts Nursing Association, or MNA, considered setting up a storefront in the Upper Valley or an office inside the hospital. The effort, and another in 2010, failed to gain traction.

In 2015, The National Labor Relations Board began accepting digitally-signed union cards, which has expedited organizing efforts across the country.

Amid a nationwide nursing shortage, DH currently has more than 600 positions unfilled at its six hospitals and clinics, most of which are in nursing or technical support.

Extended wait times across clinics are exacerbated by bed shortages and the inability of DH to discharge people to lower levels of care, such as nursing homes. In February, DH warned patients about especially long lines in the emergency department.

While DHMC has fended off unionizing efforts over the years, nurses at other hospitals across New England have voted in support of collective bargaining.

Nurses in the University of Vermont’s hospital system have been unionized since the early 2000s. In 2022, nurses at Maine Medical Center in Portland ratified their first union contract.

Nurses at Springfield (Vt.) Hospital unionized in 2022 as well.

One of the more profound impacts of the union has been monthly meetings between union members and hospital administration “to discuss issues in the hospital and come up with collaborative solutions,” said Alicia Reed, president of the Springfield union.

The union has also negotiated wages scales and helped to implement a staffing grid to pace out scheduling, Reed said.

Labor activity in regional peer hospitals draws the attention of non-unionized medical providers, said Deb Snell, president of the UVM Medical Center union.

It was no coincidence that DH started offering signing bonuses of more than $20,000 when UVM nurses went on strike in 2018, Snell said.

“When (DH) sees things happening here, they react,” she said on Friday. “Throw out some treats to the nurses. It’s like carrot and stick. But at some point the carrot is going to rot.”

Snell rebuffed any characterization of unions inhibiting conversation between employees and management. She and other UVM union officials have weekly meetings with t he chief nursing officer, and meet every other month with the hospital president.

“Obviously the (DH) nurses there don’t feel like that dialogue is really happening,” Snell said.

“The union saying is: ‘There isn’t a union that management didn’t help create.’ ”

Frances Mize is a Report for America corps member. She can be reached at fmize@vnews or 603-727-3242.