Asheville Nurses Union Vote Unprecedented in North Carolina

The exterior of Mission Health's Cancer Center.
Mission Health

Carolina Public PressBy Kate Martin, Carolina Public Press.

In what the union hailed as a “landslide vote,” nurses at Mission Hospital in Asheville recently voted to approve a union — the first in North Carolina to do so and the largest hospital union win in the South since 1975.

National Nurses United, the labor group that now represents about 1,800 nurses at two addresses in Asheville, said in a statement that it believes this is “the largest union election win in the South in a dozen years” for a union of any type.

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“We’re all thrilled that we’ve finally won,” said Lesley Bruce, a registered nurse, who works in chest pain observation at Mission. In her statement, she added, “This victory means we can use our collective voice to advocate for patient safety and safer staffing.”

Nearly 1,400 people voted, and the ballots were counted from late Wednesday into early Thursday, Sept. 16-17. Of those, more than 70%, or 965, voted in favor of a union.

A spokesman for the National Labor Relations Board said 100 ballots were challenged by one side or the other, but even if all of them voted against the union, the outcome would be the same.

HCA signals questioning results

In a statement sent shortly after the vote, Mission Health/HCA Healthcare North Carolina Division spokeswoman Nancy Lindell said the company respects the nurses’ right to decide on a union but hinted the fight may not yet be over from its end.

“In the coming days, the hospital will thoroughly examine the election process and the manner in which the election was conducted,” Lindell said.

“The NLRB’s process allows both parties time to review the election and the conduct of the parties prior to the election; the hospital may utilize that process to ensure that all of our nurses had the fair election that they deserve.”

Bruce Nissen, a retired labor studies professor at Florida International University, said HCA’s language hints at months or even more than a year of “exploiting loopholes in labor law” to draw out the union organizing process as long as possible.

“They are talking about not accepting the results,” Nissen said of HCA’s statement.

But because of the large margin of victory, Nissen predicts that “further resistance by HCA is not going to be successful, and there probably will be a really strong union there because of the struggle the workers had to go through to establish a union.”

Once the dust settles, the nurses and HCA will hammer out a collective bargaining agreement, which outlines working conditions, pay and raises. NNU represents nurses at 19 other HCA hospitals across the country, the majority of which are in Florida.

The NNU vote count exceeded most others conducted recently by the NLRB, in which many efforts had only a handful or a few dozen votes involved.

Collective bargaining by public employees is banned in North Carolina, but Mission Hospital workers are not public employees. Workers in North Carolina don’t have to join a union and cannot be forced to pay union dues under the state’s “right to work” laws.

North Carolina has the second-lowest percentage of union-represented workers in the country, at 3.4%, according to Bureau of Labor Statistics data released last year. Only South Carolina has a lower percentage of its workforce unionized, at 2.7%.

According to its website, Mission Hospital is hiring dozens of nurses in a variety of fields. HCA bought nonprofit Mission and its suite of North Carolina hospitals and clinics for $1.5 billion in early 2019. It was then that many nurses started talking about forming a union.

Last fall the hospital raised its minimum wage to $12.50 per hour, with $15 for nursing support positions. Nurses may also qualify for tuition reimbursement of up to $5,250 per year.

Contentious process

Asheville nurses ramped up their talk of forming a union in March, with new parent company HCA Healthcare pushing back against allegations of poor working conditions.

Around the same time, N.C. Attorney General Josh Stein sent HCA a list of questions prompted by consumer concerns, including those regarding the quality of health care and staffing at the Western North Carolina hospitals.

HCA in turn sought to delay the union vote, citing the pressures from the new coronavirus. At the time, in mid-March, hospitals around the region were bracing for a predicted influx of patients suffering from COVID-19.

Initial hearings with the NLRB were delayed again, in part due to the effects the coronavirus had on public life. Nurses were eventually able to cast ballots in mid-August.

Nurses have accused HCA of forcing them to attend anti-union briefings on the clock during the ongoing pandemic. HCA called the sessions “an important investment” to provide factual information and inform nurses of their legal rights under the National Labor Relations Act.

The vote count was conducted over streaming video, with some NLRB staff physically handling the envelopes and ballots while lawyers for both sides watched remotely. Normally, such a tally would be done in person, but COVID-19 has changed even this.

Game changer?

Nissen, the retired labor professor, said the resounding union vote at Mission could be contagious. Unions in the South have faced headwinds because of the history of slavery and racism, he said.

“The South has always been the Achilles heel of the U.S. labor movement,” Nissen said.

“There’s been very few victories for unions in the South, and very, very few of them of this comparable size. It could have a major impact on the fate of organized labor and unions in the South.”

Carolina Public Press is an independent, in-depth and investigative nonprofit news service for North Carolina. Kate Martin is lead investigative reporter for Carolina Public Press. Email her at [email protected].