Labor analysts say doctors have jumped to the front of the line of healthcare workers forming unions while others in the medical field continue to show interest, including nurses at a hospital in the North Dakota region.

Nurses at the CHI St. Francis Health Breckenridge hospital along the border with Minnesota now have a collective bargaining unit.

Connie Okeson, a registered nurse at the hospital, said she hopes voting to form a union allows her team to illustrate staffing issues. She emphasized they have to fight to make health facilities in smaller towns and cities desirable places to work.

"A lot of new nurses, they're not interested in working in small towns because we don't have all the things they want to do in a hospital," Okeson pointed out. "It's more low-key. But I'm hoping by doing this that we can bring those ancillary services back. And then, maybe more nurses will want to work at St. Francis."

CHI leaders could not be reached for comment. Since coming out of the pandemic, labor organizing in health care has gained a bigger following. Nurses were among those leading the charge, but the Journal of the American Medical Association said the movement has caught on with physicians. Doctors led nearly 30 union drives the past two years, well above yearly averages the past two decades.

St. Francis Breckenridge is a 25-bed critical access hospital serving a handful of communities. Corporate consolidation remains a force within health care and Okeson noted nurses want to be part of the wave giving workers at not-so-big facilities a bigger voice.

"I'm hoping it opens it up for (workers at) other small hospitals to do the same," Okeson stressed.

She added having more input can improve patient care, aiding the reputation of small-town hospitals and making sure they stay on as a key employer for these communities. Negotiations involving her colleagues are expected to begin within the next six to eight weeks.

More than 1,100 caregivers at Portland's Providence St. Vincent Medical Center have voted to unionize, joining the Service Employees International Union Local 49.

Hospital staffers, including certified nursing assistants, cooks, lab assistants, pharmacy techs, environmental workers and patient representatives, will soon begin collective bargaining with management over a new work contract.

Finn McCool, senior food service attendant at Providence St. Vincent Medical Center in Portland, said changes to working conditions in the hospital were a major driver to organize.

"There's a lot that makes St. Vincent a great place to work, but we've also seen just tons of changes over the years around staffing and benefits," McCool explained. "My fellow caregivers really knew that jobs were only going to get harder."

The St. Vincent caregivers will join thousands of other unionized workers at Providence hospitals in Oregon, Washington state and other parts of the country. Providence officials released a statement, recognizing the union and saying they were prepared to work with it toward a new contract.

McCool noted the company made several changes to staffing and work policies without feedback from its employees, with changes to the employees' health care benefits causing a major upheaval.

"It's been a recent change to our health care plan with Aetna switching over, and that was probably a very large reason why a lot of us decided to vote yes," McCool pointed out. "We had our own internal health care system. We changed to a different thing. Co-pays changed. Things were definitely a lot harder with increased deductibles."

McCool stressed political uncertainty, particularly in the government's health care policies, was also a significant concern.

"We're seeing a lot of changes going on with the government with cuts, especially right now," McCool observed. "What threatens us is cuts to Medicare and Medicaid. Our CEO said, 'These cuts are threatening the hospital.'"

The multistate Providence Health System announced it will close the maternity center at one of its Montana hospitals in October.

Opponents are hoping the corporation will reverse its decision at negotiations starting next week. The Family Maternity Center at Missoula's Providence St. Patrick Hospital has delivered about 450 babies each year over the last several, and serves many people from the surrounding small towns.

Robin Haux, labor program director for the Montana Nurses Association, said the layoff notification came as a big surprise and will affect moms and babies, nurses and Missoula's other hospital.

"Not only were the nurses provided just a four-month turnaround, so was the community, so was Community Medical Center," Haux explained. "This has triggered a pretty large scrambling of trying to get prepared."

The cut comes as U.S. lawmakers close in on the "One Big Beautiful Bill Act," the Republican budget megabill proposing cuts to Medicaid which could close rural hospitals. Providence said the closure is due to "declining birth volumes" and "workforce shortages."

Megan Carey, labor and delivery nurse in the Family Maternity Center at Providence St. Patrick Hospital, said no one from the Family Maternity Center was included in the decision.

"We were told there was a discernment team as well as external stakeholders," Carey pointed out. "It's just really disappointing that administration could not look inward to better go about this process."

Carey added Providence sent what she calls an "unsettling" message informing nurses they could apply to work in other departments at St. Patrick Hospital but there would not be enough jobs for them all.


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As more women enter the construction industry, a group in Philadelphia is working to support them and advance diversity amid political challenges to DEI programs.

The U.S. Bureau of Labor Statistics reports a nearly 45% increase in women in construction over the past decade.

Amy Novak, president of the Philadelphia chapter of Professional Women in Construction, said recent federal actions against DEI initiatives have prompted the relaunch of their empowering committee, which focuses on development and educational sessions.

"We choose to focus on empowering women to solve issues, be a part of the resolution of issues," Novak explained. "And also to feel supported, to be an advocate for diversity, equity and inclusion programs."

The Biden administration implemented widespread diversity, equity and inclusion initiatives across nearly all areas of the federal government from military operations to airline safety policies. Critics argued the programs amount to unlawful and unethical discrimination.

Novak said a recent Professional Women in Construction report showed strong support for diversity, equity and inclusion among those involved with the group. She added her group is committed to growing the talent pipeline in construction, architecture and engineering from trades to professional roles by expanding partnerships that boost early STEM interest, starting in middle school.

"We have our Connecting Committee, which goes out and regularly interacts at college campuses," Novak pointed out. "Not just to women who are in engineering, architecture, construction majors, but those majors as a whole, educating them about different careers within construction."

Novak stressed the goal is to expand into high schools next year, to reach students as they start making career decisions. She added the group's Student Recognition Program, launched in 2020, highlights young women pursuing careers in STEM and construction, aiming to inspire younger girls and strengthen the future talent pipeline.


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