Baltimore Nurses Just Made Union History

Nurses at Ascension Saint Agnes Hospital became the first to unionize a hospital in Baltimore, Maryland. On November 2 and 3, 2023, more than 500 nurses voted to join the National Nurses Organizing Committee/National Nurses United (NNOC/NNU). They had filed charges with the National Labor Relations Board against Ascension Health over alleged interference with their organizing, and they say the union gives them real representation to address severe staffing shortages, recruitment and retention problems, and patient care.

With more than 225,000 members, including 2,500 nurses from the 139-hospital Ascension system, NNOC/NNU is the largest nursing union and professional organization in the country.

"I am thrilled to welcome Saint Agnes nurses to NNOC/NNU on behalf of our over 225,000 members," NNOC/NNU President Jean Ross, RN, said in a statement. "Your tenacity and commitment are an inspiration to your union siblings across the nation, and we look forward to working with you to achieve quality care at your hospital and for all patients."

The effort began in September, when the nurses filed charges with the NLRB against Ascension Health, one of the largest nonprofit Catholic hospital systems in the country. The filing came a month after Archbishop Borys Gudziak of the U.S. Conference of Catholic Bishops underscored the role unions play for working families, writing that they "should continue to be supported in their work that supports healthy, thriving families, especially those who are most in need."

The charges against Saint Agnes alleged that management interfered with organizing and used illegal tactics. The NLRB opened a federal investigation. According to NNU, the unfair labor practice charges included:

• Unlawfully threatening to withdraw and withdrawing benefits from employees because of the union's representation petition
• Unlawfully promising or granting benefits to stifle the organizing campaign
• Unlawfully soliciting grievances to stifle the campaign
• Maintaining and enforcing an unlawful no-solicitation policy to bar off-duty employees from discussing the union
• Unlawfully surveilling employees engaged in union or other protected activities
• Unlawfully denying Weingarten representatives to nurses called into investigatory meetings related to union activity
• Telling employees that selecting a union would be futile because the employer would not bargain over certain mandatory subjects

The nurses would go on to elect representatives, define their priorities, and bargain a first contract with Ascension.

Nurse Strikes on the Rise

Union nurses have the legal right to strike, and strikes have risen since the COVID-19 pandemic exposed deep problems in hospitals. The early concerns over PPE shortages gave way to nurses speaking out about burnout, workload, mental health, low wages, and unsafe staffing.

Roughly 100,000 nurses left the workforce during the pandemic, according to the NCSBN. In a pulse survey of inpatient nurses by the American Nurses Foundation, the share planning to leave the profession rose from 35 percent in fall 2022 to more than 40 percent in March 2023.

Many who stay, and who are represented by unions, have won. Nurses and other health care workers at Kaiser Permanente ratified a four-year contract that ended the largest health care strike in U.S. history, securing raises, bonuses, safer staffing, and a redesigned performance-sharing plan. Union nurses at Allegheny General Hospital in Pittsburgh avoided a strike by ratifying a three-year contract that promised raises, new hiring, and better nurse-to-patient ratios.

Joining a union has tradeoffs, but organized nurses have a stronger hand in negotiating benefits and working conditions. Saint Agnes nurses now have that representation through NNOC/NNU.