Stepping into a highly needed role at the beginning of the COVID-19 pandemic, nurses have played a crucial and often underappreciated role in hospitals since, a spokesperson from SEIU Healthcare Wisconsin said. During the pandemic, nurses faced traumatic turnover experiences which left the staffing problem in disarray, according to the health care workers union.
University of Wisconsin Health nurses’ union efforts serves to highlight how nurse drawbacks created notable deficiencies in UW hospitals.
The UW Hospitals and Clinics Authority includes UW Health, East Madison Hospital and American Family Children’s Hospital. The system employs 3,400 nurses, including 2,600 nurses in the union, according to the Milwaukee Journal Sentinel.
In 2019, nurses signed union cards calling on UW Health to recognize them, but the board refused. In early 2022, 1,500 nurses signed union cards and presented them to the UW Health administration but were not acknowledged, ultimately leading to a vote for a strike.
Later, in September 2022, the strike was averted by an agreement between UW Health and the nurses. The union voice was reestablished, but the nurses did not gain the right to bargain a contract. The right to collectively bargain a contract would mean the nurses would work with UW Health, and through a representative they both agree on, establish agreements for better working conditions or compensation.
The turnover experience
Nurses faced many challenges regarding the pandemic and staffing shortage, leaving hospitals understaffed, according to a spokesperson with SEIU Healthcare Wisconsin.
“It was a little surreal,” UW Health Nurse Mary Jorgensen said. “We had shortages and issues before COVID. But COVID just exacerbated them, so a lot of nurses have left the field since then [due] to distress and [from] PTSD. We have been really struggling post-COVID with staffing.”
UW Health currently faces a vacancy rate of 10% while the national average of vacancy rates for nursing positions is 17%, leadership at UW Health shared in a statement with The Daily Cardinal.
The turnover rate for nursing positions at UW Health is less than 12%, compared to the national turnover rate of 21%, the statement said.
“Our benefits and compensation compare favorably to other regional health systems and to peer organizations throughout the country,” UW Health noted.
UW Health nurse Sarah Langland said the low turnover rate does not translate to a representation of the nurses’ struggles.
“There is still vast room for improvement, and even at 12%, it takes an average of like 50 nurses on a unit — losing seven to eight nurses,” Langland said. “Well, that's like three to four nurses per shift. That's a huge impact.”
Plan of action
Strategies to mitigate the shortage and increase the number of nurses in the field include the internal nurse traveler program, two nurse residency programs and “significant” tuition reimbursements for employees in nursing, according to leadership at UW Health.
The “Internal Traveler Program” is an incentive in which UW Health pays nurses to take on more shifts. Additionally, UW Health hired outside traveling nurses, which is often costly, to fill staffing gaps in the short term, according to the SEIU Healthcare Wisconsin spokesperson.
Leadership at UW Health is also committed to the “meet and discuss” process of open conversation between the administration and nurses, according to leadership at UW Health. It was created in September by UW Health and the SEIU.
“The agreement ensures that this process will continue while any court proceedings are pending to determine whether nurses at UW Health can legally obtain union recognition and collectively bargain,” leadership at UW Health explained in their statement to The Daily Cardinal.
While these programs signal significant and positive change, nurses still describe setbacks they believe need to be addressed.
Nurses at UW Health work anywhere from 13 to 16 hours a day. Nurses who travel don’t have a sufficient amount of time for commuting or winding down from work, according to Langland and Jorgensen.
Many of Langland's coworkers diverted to other hospitals offering higher wages, therefore not requiring them to pick up overtime, she said.
“It's very hard, mentally and emotionally, to come in and want to provide the best care for your patients, but you're still struggling with the short staffing,” Langland said.
UW Health has several specialized units, such as cystic fibrosis, which require in-depth knowledge about the disease and dedicated staff to manage specialized medications like those used for pulmonary hypertension, Langland explained.
“I've worked with awesome [traveling nurses], but they're not core staff,” Langland said. “They're not staying, they're not becoming experienced.”
Jorgensen agrees the program may pose long-term instability.
“Although we appreciate the opportunity to make more money, they're basically asking nurses who are already working full time, burned out, to work even more,” she said.
Numerous nurses left their occupations due to burnout or switched to non-direct patient care roles such as research. Others pursued further education and training to become nurse practitioners, according to Langland.
While UW Health is recruiting and hiring, they’re not working to retain their experienced and established nurses, Jorgensen said.
“In the end, short staffing ultimately needs to be addressed in a more sustainable manner,” Langland added. “That was one of our main focuses with a nurses union — was to address things like that so that we can overall create an environment of better care.”
The “meet and discuss” process has allowed UW Health nurses to formally connect on a regular basis as a united voice for the first time since 2014.
“Even though it can be kind of hard from the outside to understand, that was actually a monumental change and a really big thing that UW did. And we appreciate that,” Langland said. “We appreciate having a voice at the table to come down and say, ‘Hey, let's meet about these things.’”
Ultimately, UW Health recognizing the nurses union would protect sharing power between the nurses and the administration, according to an SEIU Healthcare Wisconsin spokesperson.
The ultimate goal is to get a written contract that will legitimize how much nurses are paid, outlining their benefits, working conditions and staffing levels, the spokesperson emphasized. The nurses are currently exploring three routes to secure a collective bargaining agreement: in the Dane County Circuit Court, in a petition to the Wisconsin Supreme Court and via a National Labor Relations Board Reelection, according to the spokesperson.
Only one success among these three routes is necessary to secure this agreement. However, they are all still in progress, the spokesperson said.
In the Dane County Circuit Court, former Gov. Scott Walker appointed a director of the Wisconsin Employment Relations Commission that found UW Health was not covered under the Wisconsin Peace Act.
The Peace Act states certain employers have the right to bargain a contract with their employees. The nurses believe UW Health meets the standards of those employers, according to Langland and Jorgensen. The nurses union appealed that decision in Dane County Circuit Court and is currently awaiting the verdict.
In early February, the Wisconsin Supreme Court rejected UW Health’s petition to determine whether they can voluntarily recognize the union.
The nurses saw this as a relief because now the petition can be sent through the lower courts, following the process from the circuit courts rather than cutting directly to the Wisconsin Supreme Court.
The nurses' third strategy in hopes of obtaining collective bargaining rights is their November petition to the National Labor Relations Board.
If the National Labor Relations Board agrees the union falls under the Wisconsin Peace Act, the nurses will hold an election to decide whether they want to be unionized and get full collective bargaining, according to Jorgensen.
“[UW Health] is the number one hospital in Wisconsin, and all the employees at UW should be treated like they work at the number one hospital in Wisconsin,” Jorgensen said. “Because when we are, then patient satisfaction is better. The care is fantastic.”
Ava Menkes is the state news editor at The Daily Cardinal. She has covered multiple stories about Wisconsin politics and written in-depth about nurses unions and youth voter turnout. Follow her on Twitter at @AvaMenkes.