University of Utah health care workers unionize

Health care workers across the University of Utah’s hospitals and clinics have unionized — a move that comes, representatives say, as employees have been sacrificing their own health to take care of patients in a system that they feel is critically understaffed.

Utah Health Workers United (UHWU) Local 7765 will be the first of its kind in the state: the only union directly tied to a specific health care system. Its members are calling for higher and safer staffing ratios per patient, as well as wage increases.

“We believe our working conditions are our patients’ healing conditions and will fight for substantial changes,” the union wrote in its announcement Tuesday.

The formation of the union, members say, was catalyzed by the COVID-19 pandemic that health care staff describe as adding rocket fuel to existing concerns with burnout. Employees say both individual workers and the health care system as a whole haven’t recovered from that, and now the situation is untenable.

Similar concerns led health care workers at multiple Kaiser Permanente hospitals across the nation last month to strike, the largest ever in the country among medical workers.

The U.’s medical network has more than 14,000 employees shared over its main hospital in Salt Lake City, the Huntsman Mental Health Institute and the Huntsman Cancer Institute, as well as clinics and community centers across the state. Another 9,000 staff and faculty work in health academics, with the hospital being the only academic medical center in the Mountain West.

Taylor Almond, a member of the union and a psychiatric technician at the Huntsman Mental Health Institute, said more than 500 employees have signaled their intent to join Utah Health Workers United. That was enough for the group to form as an affiliate of the Communications Workers of America without requiring a vote or petition.

The organization gave notice to University of Utah Health on Tuesday morning and launched its website for interested members to sign up and begin paying dues.

Kathy Wilets, the spokesperson for the U.’s health system, said in a statement that the company is “prohibited from recognizing organizations for purposes of collective bargaining.” But, she added, the system is willing to talk to employees “to continually improve working environments and to discuss any concerns.”

She said all employees received an annual pay increase this year, and University of Utah Health regularly looks at national compensation data “to ensure we’re competitive with our peers” and to retain talented staff.

Utah is not considered an anti-union state, but public employers are not required to negotiate a contract or even recognize a union. It’s a “right to work” state, and statute only says that employment cannot be “denied or abridged” based on participation in a union.

The U.’s employee guidelines specifically state: “The university neither encourages nor discourages the establishment of employee organizations for lawful purposes. In accordance with this policy of neutrality: Every employee is recognized to have the right to join, or to refuse to join, an employee organization. For the purpose of this policy, ‘employee organization’ includes a labor union or association.”

The state has seen a rise in local labor unions in recent months, including one at a cannabis dispensary and another for Salt Lake City library workers. There are several existing medical associations, including the Utah Nurses Association and the Utah Medical Association, that represent health care workers; those members can be independent workers or from any of the four major health systems in the state, which are: Intermountain Health, MountainStar Healthcare, CommonSpirit Health (formerly owned by Steward Health Care) and the U.’s system.

Utah Health Workers United is specific to U. employees, though members can hold any position (as long as the staffer does not have hiring or firing authority) — nurse, technician, scheduler, pharmacist, custodian, physician assistant, valet, EMT.

Almond said the union intends to use the dues it collects — it is asking for members to contribute 1% of their net salary — to organize, campaign and force the U. to participate in negotiations. Almond makes about $28,000 take-home pay a year as a technician, he said, which means he would give about $18 a month to the union; employees, though, can elect to give more or less.

Utah Health Workers United wrote in its announcement: “The members of this union provide exceptional care under difficult circumstances, as evidenced by the numerous rewards our system has received. We have not been treated like award-winning employees.”

Demand No. 1: Better pay

A big push by the union is increasing compensation. It’s a crucial part of valuing employees and retaining them, said Sarah Greaves, a patient relations specialist in the U.’s system.

There has been a spike in employees quitting, she said, because of burnout following the pandemic. The hospital can’t get a new hire to take that spot, Greaves believes, because the pay is too low. She called it a “negative feedback loop spearheaded by inappropriate base compensation.”

“Someone resigns, and we are expected to perform the jobs of two people with no additional compensation, while management struggles for months to hire replacements,” she said in a statement.

Meanwhile, it is the experienced health care workers who most often leave for better pay, Greaves believes, and less experienced ones are hired to fill the gap.

Almond said the union is asking that staffers make a livable wage for the increasing cost of living along the Wasatch Front. Greaves said she is spending 50% of her pay on rent, while living in an income-restricted apartment.

Utah Health Workers United is basing pay demands on each specific position within health care. And it’s looking at peer academic medical centers and similar cities for comparison.

The union specifically looked at Oregon Health & Science University Hospital in Portland, which is an academic medical center and has a nurses union; Portland and Salt Lake City also have similar costs of living. After a contract with the nurses union in Oregon was approved this year, the starting wage for a nurse there is now $53.50 an hour.

At the U.’s hospital, it’s $32 an hour, according to Utah Health Workers United. A petition from 2022 to increase the pay for the U.’s nurses had nearly 5,000 signatures but did not appear to immediately prompt any changes.

Meanwhile, John Hunter, the CEO of Oregon Health & Science University Hospital makes $1.15 million a year, with benefits. Michael Good, who oversees University of Utah Health as the system’s CEO, makes nearly double that at roughly $2 million a year, including benefits, according to Utah’s government salary transparency website.

“I sacrifice for my patients,” said Almond. “All I want is for the university to do their part. Their finances are public — we know they can treat us fairly. They don’t even need to sacrifice. They just need to do the right thing.”

Almond said staff will get extra pay for taking on extra shifts. But the standard salary should be enough to live on, he said, without having to do additional work beyond 40 hours a week.

Demand No. 2: More staffing

Almond, whose job requires working with those often in mental distress, said he has been bitten by patients, punched and last month was pushed by one, breaking his thumb. He said he loves his position and cares about patients getting better, but the low pay and short-staffing are making it unmanageable — and the latter, he feels, contributes to an increase in risks and injuries to health care workers like him.

The U.’s health care system, like many across the nation, works on a “just in time” staffing system, meant to have as few workers per shift as needed to cover patients. More employees are called in only as needed, such as when there is an influx of patients or increasingly sick patients who need more attention.

Almond said in his unit, there typically is a ratio of one nurse per 10 patients. At a California hospital’s psychiatric department that the union looked at, he said, there is one nurse per six patients.

The staffing at the U., he said, is “too low for the kind of care that we need to provide.” There should be staff to de-escalate patients, draw up medication, coordinate with technicians, Almond said, instead of one nurse trying to juggle it all.

“It makes everything much safer for everyone,” he said.

Studies have shown that unionized hospitals tend to perform better on key safety metrics than non-unionized hospitals, largely because they retain experienced staff. Health care costs, though, for patients often increase at unionized hospitals.

Fania Bevill, a nurse for 23 years and a member of the union, added: “So many employees go above and beyond — without breaks, staying late — to give our patients the best care. It causes moral distress to know the high level of care we want to provide, but in order to provide that care we have to sacrifice our physical and mental health because there aren’t enough staff.”

Utah Health Workers United doesn’t have specific staffing ratios in mind yet, but is looking at possibilities. It also is exploring possibly lobbying the Utah Legislature for safe staffing measures, which require a certain ratio of nursing staff in hospitals, for instance; laws on that have passed in California and Oregon.

The union says that current efforts by the university to address concerns are insufficient. The U. has been hosting some listening sessions, but Utah Health Workers United says staffers are often told not to talk about staffing or wages during those.

Utah Health Workers United is calling for “immediate actions” by the university to address concerns. It doesn’t have a specific timeframe for that demand, but members will have a meeting on Saturday to meet and talk about their priorities.

Almond noted the U.’s system is currently rated in the Top 10 nationwide for quality. He said employees want it to be No. 1, and they believe the union can help with that goal they believe is shared by leadership.

Editor’s note: Paul Huntsman, chairman of the board of The Salt Lake Tribune, is a member of the Huntsman family, who are the major benefactors of the Huntsman Mental Health Institute and Huntsman Cancer Institute that operate as part of the University of Utah Health system.