Des Moines Nurses Push for Union Recognition
Whitney Armstrong never expected to find herself in the position of being a union organizer. But the critical care nurse at Iowa Methodist Medical Center says she was raised with the idea of “being the change you wish to see in the world.” She came to realize, “If that means I help organize a union, then that’s what I’ll do.”
Iowa Methodist is one of four hospitals in Des Moines operated by UnityPoint Health, formerly Iowa Health System. The nonprofit provider runs hospitals, clinics, and home care facilities in Iowa, Illinois, and Wisconsin. Working at Iowa Methodist for nearly ten years, Armstrong says she was at first impressed by “the attitude, the behavior, and the energy” of the working environment.
“It really did seem like the nurses were valued,” Armstrong recalls. But that did not last: “Over the past couple of years, we’ve definitely seen a shift in the behaviors and attitudes of our upper management.”
Alex Wilken, an intensive care unit nurse at Iowa Methodist, has been working with UnityPoint since 2010, starting as a nursing assistant until receiving his nursing license in 2014. Since then, he has worked in several departments at the various UnityPoint hospitals.
“The way they [UnityPoint executives] have compensated different groups of nurses is unfair and makes no sense,” Wilken says. “It seemed like the administration was increasing the pay for newer nurses coming in, and not especially incentivizing those of us who stuck around for so long, and not rewarding the loyalty and keeping our experience there. It seems like their priorities are not in the right place.”
United Nurses of Iowa members have been organizing the support necessary to file with the National Labor Relations Board. Olney said in late November that she is optimistic that a vote on unionizing could be held “within a month or two.” Then they could begin the collective bargaining process with management for a union contract. The union, if successful, would represent about 1,550 nurses at the four UnityPoint hospitals in Des Moines. (Besides Iowa Methodist, these include Methodist West Hospital, Blank Children’s Hospital, and Iowa Lutheran Hospital.)
“I’m incredibly optimistic,” says Wilken. “It’s amazing to see, especially since we went public, all of the different people who’ve stepped up to help organize their specific units. This thing has really taken off.”
The COVID-19 pandemic changed the landscape of the health care industry, creating a nightmare of overcrowded hospitals, staffing shortages, and rationing of care. Despite being called “heroes” as essential workers on the frontlines of a global health crisis, they began to feel, as registered nurse Carly Olney told the Des Moines Register, like “disposable labor.”
Armstrong says bedside nurses at UnityPoint Health are being tasked with an “unreasonable workload.” Instead of taking care of roughly five patients, the nursing staff was now tasked with caring for seven or eight during the day and as many as nine or ten at night, Armstrong says. “That just doesn’t allow the type of nursing we were all hired on to do.”
Back in late September and early October, UnityPoint introduced a new policy of “shift differentials.” Under the previous policy, nurses were paid extra for working “undesirable hours”—shifts in the early morning, late at night, and on holidays. The new policy requires nurses to work four consecutive hours of a non-traditional time in order to qualify for the differential, costing them thousands of dollars a year. “These nurses are doing the same work with the exact same people, the same patient population, [and] are going to get less to do it,” Armstrong says.
Nurses at Iowa Methodist Hospital met with management on several occasions to challenge the new policy, without success. A petition was circulated on Change.org to rally support for reversing the policy change. According to the petition, “Many nurses, who have been here for years, are now receiving 4 to 5 percent of a salary decrease.”
According to national figures on nurse compensation compiled by the U.S. Bureau of Labor Statistics, the median pay for registered nurses in 2023 was $86,070 per year, or $41.38 an hour. Iowa ranks near the bottom of the list in forty-eighth place, where the median salary for nurses is $71,570 per year, or $34.41 an hour.
UnityPoint executives have awarded themselves bonuses equal to a nurse’s annual salary while claiming there isn’t money to increase salaries. “They have told us many times over the past several years that they can’t afford to give nurses any more money than what they’ve already been paying them,” Armstrong says. “They allege it’s a fair market value for our services.”
There are more than 33,000 registered nurses in Iowa. Employment for registered nurses is expected to grow by 6 percent in the next decade. But the nurses at UnityPoint worry that Iowa’s wage stagnation and rising costs of living will cause graduating nurses to go to neighboring states, such as Minnesota, where wages are higher and benefits are better. Iowa’s elderly population is facing what has been called a “gray tsunami” health care crisis due to staffing shortages and facility closures.
“That’s not what I want for my parents; that’s not what I want for my patients,” Armstrong says. “I want to be able to retain nurses, train good nurses, and keep them here because that’s what our population deserves.”
As a husband with two young children, Wilken says getting health care that “won’t cost as much and has better coverage,” for him and his family is a top priority he wants to see addressed during negotiations.
The organizing push in Des Moines is part of a nationwide surge in union activity among nurses and other healthcare workers. Catalyzed by staffing shortages and deteriorating safety conditions during the pandemic, nurses have sought unionization and gone on strike with increasing frequency over the past few years. Their efforts have led to recent successful unionization drives at hospitals such as University Medical Center in New Orleans, as well as historic and effective strikes in Minnesota and New York.
The nurses at UnityPoint met with different union representatives before settling in on Teamsters Local 90. On November 26, Teamster leaders and more than fifty nurses turned out to show their support during a rally and press conference. They are calling for safer workplace conditions for patients and nurses, improved staff ratios, higher wages, transparent pay prices, affordable health care coverage, secure retirement, and an improved time-off structure.
This effort has been met with what Armstrong calls “text-book union-busting where they have worked really hard to spread lies about the union.” Some examples: “If we unionize, any shared governance they have will go away, supervisors won’t be able to help on the floor.” These and other claims, she says, are “completely incorrect.”
When the union effort became public, organizers were met with a flood of support and solidarity from nurses and other unions. A second Change.org petition supporting the nurses’ union has nearly 1,500 signatures. A private Facebook group for UnityPoint nurses has swelled to over 1,100 members.
“It’s a natural progression for a lot of us, because we got into health care to take care of people,” Armstrong says. “We are in that role because we care about our patients, but we also care for our fellow nurses. The treatment of our fellow nurses isn’t fair, and that’s not right.”
The Progressive emailed requests for comment to two UnityPoint Health media contacts but did not receive a response. Sarah Brown, system chief nursing officer at UnityPoint Health, said in a statement: “We are committed to working directly with our nurses to address their concerns, to learn from their feedback, and make the changes necessary to create a better workplace.”