Jim Kenyon: Time for DHMC nurses to get organized?


Valley News Columnist

Published: 03-02-2023 1:45 PM

On two occasions in the last 15 years, Dartmouth Hitchcock Medical Center nurses have initiated union drives only to see the efforts fizzle out.

Will this time be different?

A group of DHMC nurses are working behind the scenes to convince their colleagues that joining a union will not only benefit them but also improve patient care.

It could also lead to nurses gaining more clout inside New Hampshire’s largest medical center. “Nurses are sick and tired of how we are being treated, particularly by upper management,” a longtime nurse told me.

“We have no voice,” added another.

For this column, I agreed not to use nurses’ names. They’re worried if they go public, DHMC management will seek retribution.

Their fear is real. Dartmouth Health, DHMC’s parent organization, has a policy that forbids its 13,000 employees from speaking publicly about the workplace unless they have permission from CEO Joanne Conroy’s communications and marketing minions.

Although the union talk is still in its early stages, nurses whom I’ve spoken with in recent days say they’re reaching a breaking point. Hiring shortages — a problem for hospitals across the country — have many DHMC nurses juggling more patients than they have in the past.

Article continues after...

Yesterday's Most Read Articles

“It’s a very different hospital than what I started at,” said a nurse who has worked at DHMC for almost 10 years. “It’s very hard to give patients the time and care they deserve and need.”

At DHMC, as is the situation at many hospitals, patients admitted these days are sicker than they were years ago. The patient-to-nurse ratio is “not going in the direction it needs to go,” the nurse added.

Nurses who work the “floor” are sometimes responsible for seven or eight patients at a time during their 10- and 12-hour shifts, I’m told. When responsible for that many patients, the risk increases that “you’re going to miss something, like when giving meds,” a nurse explained.

Nurses say they bring up their safety and workload concerns in meetings with DHMC management; however, they get little but lip service. Management will “yes us to death, but nothing changes,” a nurse said.

Most nurses see themselves as advocates for the patients they’re caring for, but it’s a role that’s become more challenging.

“I worry about losing the art of nursing,” a nurse with 30 years of experience said. “Health care has changed.”

In the same-day surgery and outpatient surgery units, which tend to be hospitals’ cash cows, it’s about moving out patients as quickly as possible to make room for new patients, I’m told.

“It’s all about the numbers,” a nurse said. “If it’s going to be run like a factory, then factory workers need unions.”

If DH’s management didn’t know about the unionization effort before, they do now.

Workforce challenges, such as staff shortages, are issues “Dartmouth Health has been engaged in addressing since before the pandemic,” Cassidy Smith, a DH media relations specialist, wrote in response to my request for comment about a potential union push.

“These are issues facing every hospital and health system — unionized or non-unionized — in the nation right now,” Smith continued. “We are committed to keeping our facilities well-staffed in order to provide high-quality, safe care for our patients.”

Along with patient care and safety issues, DHMC staff nurses are also concerned about pay inequities. DHMC pays some traveling nurses, whose stays typically range from 13 to 26 weeks, $80 to $100 an hour, I’ve heard. Meanwhile veteran staff nurses often earn less than $50 hour.

“The organization has undertaken an ongoing review of our compensation levels for all employees, and we have made a number of market adjustments to compensation rates,” Smith said.

In 2002, nurses at what is now the University of Vermont Medical Center in Burlington voted to form a union. The Vermont Federation of Nurses and Health Professionals now represents more than 2,000 UVM Medical Center employees. Nurses pay 1% of their annual salary in union dues.

Last July, the union and the medical center agreed to a new contract that gives nurses a 20% pay raise over two years.

“It’s about fairness,” Deb Snell, president of the UVM Medical Center union told me in an interview last summer. “Without a union, you’re on your own.”

In 2021, nurses at Springfield (Vt.) Hospital, which isn’t affiliated with DH, voted, 35-25, to unionize.

At large hospitals, unionization efforts take months, if not years. Union organizers look to have around 70% of eligible employees sign so-called pledge cards, which can now be done online, before seeking a vote under the auspices of the National Labor Relations Board.

DHMC and its clinics have about 2,500 nurses. (Traveling nurses, who make up a significant portion of the workforce, aren’t eligible for union status.)

If the unionization effort gains any traction, it’s almost certain that DH’s management will hire big-time consultants in an attempt to quash the movement.

“We have to be careful,” a nurse said. “We talk about it only during our (work) breaks.”

DHMC nurses initiated union drives in 2008 and 2010, but both proved unsuccessful.

Nurses are optimistic that this time will be different. In May, DHMC is set to open a $150 million patient tower, which figures to increase the demand for nurses.

In a tight labor market, DHMC nurses have more leverage than during the two previous drives. Nationally, the number of nurses voting to form unions is on the uptick, The Washington Post reported in January.

“We are seeing an upsurge of nurses that are saying, ‘We’ve had enough. We want to organize. We really want our hospital to hear what we have to say,’ ” Cathy Kennedy, president of the California Nurses Association, said in the story.

As a DHMC nurse told me, “it’s got to start somewhere.”

Jim Kenyon can be reached at jkenyon@vnews.com.