Literature Review

2025 ushers new era in physician unions Becker's Hospital Review; by Kelly Gooch; 1/17/25 While unionization among healthcare workers and professionals is a familiar phenomenon, resident physicians and fellows joining unions has only grown in recent years. Indeed, since the start of 2025 alone, at least five groups of resident physicians and fellows have opted to form unions at their health systems. "Physician unionization has massively increased since 2020, especially among interns and residents," Rebecca Givan, PhD, associate professor of labor studies and employment relations at Rutgers in New Brunswick, N.J., told Becker's. ... Dr. Givan pointed to an increasing number of staff physicians unionizing as well. In 1998, the American Medical Association estimated that between 14,000 and 20,000 physicians belonged to unions. That number grew to 46,689 in 2014, and reached 67,673 in 2019. 

Sierra Hills strike ends, negotiations ongoing with parent company Wyoming Tribune Eagle; by Noah Zahn; 1/9/25 Employees of Sierra Hills Assisted Living concluded their strike on Jan. 2, and on Tuesday, the union met with Edgewood Healthcare, which owns Sierra Hills, for another contract bargaining session. ... Throughout the strike, employees said they were fighting for a better contract primarily for the health and safety of the residents and the employees, claiming the existing working conditions are unsafe. ... Wilkinson said the primary concern of the employees is safety issues that result from employees performing out-of-scope duties. ... For Sierra Hills staff, [being required to provide out of scope care] began when Edgewood introduced hospice care at Sierra Hills a few years ago, shortly after the pandemic. There are hospice nurses who are at the facility a couple of hours per week to care for the residents, but the rest of the time, the burden of care often falls to the CNAs and RNs on the clock. In situations where timely care is needed, employees have said it can be difficult to get the help of a hospice nurse in time.

4 new healthcare laws in 2025 Becker's Hospital Review; by Kristin Kuchno; 1/3/25 Through recently passed ballot initiatives and legislation, states across the U.S. are implementing healthcare and workforce-related changes in 2025.

Sierra Hills employees strike for safer conditions to live and work Wyoming Tribune-Eagle, Cheyenne, WY; by Noah Zahn; 12/26/24 Employees at Sierra Hills Assisted Living protested Thursday outside the facility after Edgewood Healthcare, which owns Sierra Hills, has refused to budge in negotiations for safer working conditions for employees and residents after more than 10 months of negotiation. “We did include many things in our contract proposal that we feel will really benefit the residents,” said Taylor Ewig, who has been a CNA at Sierra Hills for around 10 years. ... There are currently between 70 and 80 residents at the facility and around eight under hospice care. Ewig and other CNAs participating in the strike said that many of the Sierra Hills residents are supportive of the strike. The issues began at the facility when Sierra Hills implemented a hospice care service a few years ago, shortly after the onset of the COVID-19 pandemic. ... The company hires hospice nurses who are only on the facility about two hours per week, according to Sierra Hills staff. The rest of that time, the burden of care for the resident falls to the staffed CNAs and RNs.

Sierra Hills assisted living employees in Cheyenne to strike over staffing issues' Wyoming Tribune-Eagle, Cheyenne, WY; by Noah Zahn; 12/18/24 In March, a resident at Sierra Hills Assisted Living in Cheyenne fell and hurt their hip and shoulder. A CNA at the facility reported that the resident could not be moved without causing shoulder pain, noting that they had likely broken their shoulder and hip, according to a report from the Wyoming Department of Health. The resident was bed-bound, in “excruciating pain” and screamed for hours, which frightened the other residents. The CNA stated this was “the worst thing she had ever experienced.” At the time, the resident was one of six hospice patients at the assisted-living facility. Sierra Hills made hospice care available at the facility shortly after the COVID-19 pandemic. When hospice nurses were unavailable, the burden of care fell to the CNAs and RNs on staff. The CNA caring for this resident in March stated it was difficult to get hospice to respond on the weekends, saying that there was an 80% chance hospice would answer a phone call and a 50% chance a hospice nurse would come to the facility. Six days later, the resident died. Editor's note: Click on the title's link to continue reading. This strike--reportedly related to staffing--appears to be related extra responsibilities on the staff, because of the hospice's limited responses on weekends. This is 2024; not 1974. How does this scenario relate to your hospice triage, hours, staffing, incident reports, community partnerships? 

Why some healthcare unions are keeping strikes short Becker's Hospital Review; by Kristin Kuchno; 12/11/24 One-day strikes and other "fixed-duration strikes" — defined as those with a short duration and predetermined time limits — are common at hospitals. While some healthcare unions have held longer or open-ended strikes, most have opted for shorter strikes in 2024. From 2021 to 2023, the majority of healthcare strikes were of a fixed duration rather than indefinite walkouts, ... Despite their brevity and predetermined endings, fixed-duration strikes still require health systems to activate contingency plans to ensure uninterrupted patient care. ... Even short strikes can have significant financial consequences for hospitals, particularly as costs for temporary staffing replacements rise, ...

Nearly 5,000 Providence workers authorize strikes Becker's Hospital Review; by Kelly Gooch; 12/5/24 Nearly 5,000 nurses, physicians, and other healthcare professionals at nine Providence bargaining units represented by two unions have authorized strikes. Members of the Oregon Nurses Association and Pacific Northwest Hospital Medicine Association from 13 hospitals and clinics across Oregon voted over the past two months, according to a Dec. 4 news release shared with Becker's. Union representatives and Providence have been in contract negotiations for more than a year, and many bargaining units remain without agreements, the release said. ...  Strike authorizations do not mean strikes will occur. If leaders of individual bargaining units set a strike date, a 10-day notice will be issued to Providence's management.

Health care workers rally at Kaiser Permanente headquarters in Pasadena as strike enters fifth week Pasadena Now, Pasadena, CA; by Eddie Rivera; 11/22/24 More than 300 Kaiser Permanente mental health workers and their supporters marched Thursday, November 21 around the healthcare giant’s regional headquarters on Walnut Street in Pasadena, marking the fifth week of a statewide strike over working conditions and patient care concerns. The Pasadena demonstration, coordinated with a similar rally in Oakland, highlighted tensions between Kaiser Permanente and its mental health professionals represented by the National Union of Healthcare Workers. ... “We’re tired of the working conditions that Kaiser’s providing for us,” said Marisela Calvillo, a licensed clinical social worker who led the demonstration. ... Calvillo said she was seeing patients every 30 minutes without breaks while struggling to complete required documentation during lunch periods. She said therapists are given approximately two minutes per patient for administrative tasks, affecting her caseload of 86 patients. 

Providence, nurses union step up war of words as new Portland-area hospital strike looms The Lund Report; by Jake Thomas; 10/31/24 Providence is accusing the state’s largest nurses union of “power flexing” after nurses at Providence St. Vincent signaled they are willing to strike in what could be another widespread work stoppage at the hospital system. The Oregon Nurses Association announced Thursday that 1,800 nurses at the hospital located in unincorporated Washington County, just west of Portland, gave union negotiators the green light to call for a strike. ... Nurses and allied health care workers at Providence’s Portland and Seaside hospitals as well as its Home Health & Hospice service went on strike in June last year. Each of the three workplaces eventually reached contracts with Providence. But the new contracts had shorter timeframes than usual because of the strikes and are set to expire on Dec. 31, 2024. All three began negotiations again with Providence management last month. 

Exploding physician union membership signals a significant labor market shift NJToday.net; 10/16/24 As of 2022, about 70,000 medical doctors in the United States, or about 8% of the physician workforce, belonged to a union—a notable increase of 26.8% since 2014. This shift reflects significant changes in the employment landscape for doctors, with nearly half of all physicians now working for health systems or large medical groups. The rise in union membership comes amidst broader labor movements in healthcare, highlighted by the 2023 Kaiser Permanente strike, recognized as the largest healthcare worker strike in U.S. history. While nurses have typically led these efforts, physicians and residents are increasingly exploring unionization as a means to advocate for improved pay, benefits, and working conditions. 

Mission Hospital nurses, HCA agree to new contract Becker's Hospital Review; by Erica Carbajal; 10/10/24 Union nurses at Mission Hospital in Asheville, N.C., have approved a new labor contract with Nashville, Tenn.-based HCA Healthcare, which owns the hospital. National Nurses United, which represents more than 1,600 Mission Hospital nurses, shared news of the new agreement in an Oct. 9 news release. The three-year agreement includes up to 29% wage increases for some nurses, a pilot program to ensure nurses can take meal and rest breaks during their shifts, new measures to ensure nurses are floated to units similar to their usual specialty, and the ability to use preferred names and personal pronouns on name badges. "Mission Hospital is so important to Asheville and all of western North Carolina," Hannah Drummond, RN, a nurse in the hospital's catheterization lab recovery unit, said in the union's news release. "This contract is another step forward to making Mission the hospital it needs to be for our patients. Nurses are the backbone of Mission Hospital, and this contract adds steel to our spine." 

‘We did it!’: West Penn nurses celebrate their new contract Pittsburgh Union Press, Pittsburgh, PA; by Steve Mellon; 9/12/24 Before Joanne Germanos had a chance to approach a podium to make her announcement, someone in the crowd called out, “We did it!” ... What Germanos and her fellow union nurses at West Penn did was win a new contract that raises pay and addresses staffing and burnout issues that the nurses say have been pushing experienced nurses out of the profession. Ninety percent of the hospital’s union nurses voted to approve the contract Wednesday. Under the three-year deal, pay for nurses will rise an average of 24%, with some seeing increases as high as 35%. By contract’s end, all nurses will make at least $40 an hour; nurses with 20 years of experience will make at least $50 an hour. ... Pay, however, isn’t the only issue. At rallies, union nurses have called on hospital administrators to address staffing and scheduling problems that can affect patient care and cause nurse burnout. They took those concerns to the bargaining table and, on Thursday, said they were thrilled with the outcome.

Majority of Mission nurses pledge support for strike vote The Biltmore Beacon, Asheville, NC; by Andrew R. Jones; 8/28/24 Nursing leaders at Asheville’s Mission Hospital said they have the pledges needed to call for a strike vote, increasing the likelihood of a significant labor action at the HCA Healthcare-owned facility if an agreement wasn’t reached this week. Local nursing representatives said that more than 800 of the approximately 1,600 registered nurses, including members of the Mission Hospital United union and non-union members, signed pledges agreeing to vote on a possible strike at the Asheville hospital, the only Level II trauma center in WNC. The vote will be held over four days, Aug. 25, 26, 28, and 29. Nurse union leaders told Asheville Watchdog that they anticipate most of the nurses covered by the union contract will authorize a strike that could last from one to three days. ... Several other unions at HCA hospitals across the nation — including those in Nevada, Florida, Texas and Kansas — are moving toward strike votes right now, nurses said. ...