Citing lost career opportunities, mandatory overtime and lowered staff levels, a number of Duke Hospital's nurses are considering forming a union.
David Miller, a spokesperson for the International Union of Operating Engineers-the organization that launched the petition drive to organize the nurses-said the likelihood of forming a union depends largely on how much the nurses want it, and on whether they can be clearly informed about their options.
"We are holding regular meetings [about unionization]-we want an educated workforce," said Miller, adding that many nurses do not realize that they have a federally protected right to form a union.
Because the issue is so contentious, many nurses at Duke Hospital declined to comment or would not give their names. But some wear badges that read "NUPA," or Nurses Unionizing for Patient Advocacy.
Improving the quality of care for patients is the main goal of unionization, some nurses said.
"Our primary responsibility is to help the patients, and we cannot do that if we are overworked," said one nurse.
The push for unionization has captured local media attention in the past weeks, resulting in coverage that Duke Hospital CEO Mike Israel says might tarnish the Hospital's credibility and reputation for providing quality care.
"These articles could undermine community confidence in our institution," he wrote in a strongly worded March 19 letter to the editor in The Herald-Sun of Durham.
With recent criticism of the health care industry as a whole, he continued, "Articles like these make false claims that can create even greater fears and apprehensions among patients and their families."
The nurses' primary concerns dealt with the mandatory 12 hours of overtime per week, a high nurse-to-patient ratio and a system that overworks incoming nurses, forcing some to leave the Hospital.
The Herald-Sun stands by its coverage as "a fair and accurate report of nurses' complaints."
Miller extolled the benefits of a union by pointing out that it would "improve [the nurses'] position in collective bargaining, as well as give them a voice in all aspects of employment."
But Brenda Nevidjon, chief operating officer of Duke Hospital, said the issue is very complex.
"David Miller is an outsider-he periodically visits, but he is not an employee nor does he live here," Nevidjon said. "There's such change going on in health care forced by the changes outside the Hospital.... Nurses are on the front line of that [change]."
Nevidjon expressed concern over the fact that some nurses were even thinking of forming a union. "I hope those who are considering it realize that the union is not always what it seems and often has its own agendas," she said.
Miller declined to comment on the number of signatures the IUOE has collected so far. To set up a vote on unionization, 30 percent of employees must authorize it through a petition. At that point, a simple majority of nurses would have to vote in favor of the idea.
Nurses at the Hospital have mixed opinions about whether unionization is necessary.
"I have always enjoyed open lines of communication, [and] I don't think there's anything a union would solve," said a critical care nurse who has spent over 20 years working in the Hospital.
A nurse in the intensive care unit mentioned that after years of experience, she has learned how to word questions to her supervisors in a way that will bring answers.
But one nurse expressed her dissatisfaction with the quality of communication between nurses and management.
"We've been standing up at these meetings-they may hear us but they're certainly not listening," she said.
Another nurse voiced concerns about the actual bargaining power of a nurses' union, pointing out that unlike workers in other professions, nurses cannot legally go on strike. North Carolina is also a right-to-work state, so workers cannot be required to join the union once established.
Michael Boucher, head of the nurses' union at the Durham Veteran's Administration Medical Center, explained his personal philosophy that unionization is not the answer to all problems. The VA has had a union since 1974.
"Unionization is to be employed when negotiation breaks down," he said, adding that the best union is one that works with management toward a common goal.
The issue of unionization at Duke Hospital has the potential to become a powerful precedent and catalyst for nurses everywhere. "Duke's is a flagship hospital, one that gets a lot of attention and visibility," Boucher added.
Nevidjon maintained that Duke Hospital's position continues to be what it has always been. "We have many internal mechanisms for all staff to raise issues [and] make suggestions on improving processes," she said.
Richard Rubin contributed to this story.
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