Hi from Tacoma! It’s me, Tammy, with a bonus newsletter Q&A.
We talk a lot on TTSG about how to achieve social change—and the frequency with which I prescribe “organizing” has become a running joke in our listener Discord. But what does it mean in practice? And if you want to organize at work, how do you start?
Julie Anderson, a primary-care nurse in Kalispell, Montana spoke with me in June about her workplace campaign at Logan Health, formerly Kalispell Regional Healthcare. She and some six hundred nursing colleagues formed a union with SEIU 1199NW in 2019, and are still trying to win their first contract. Early last month, after months of delay and bad-faith maneuvering by management, the nurses went on a three-day strike. They have also fought dissent from within: a campaign by a small minority of nurses to decertify SEIU and return to the non-union status quo.
I reported a bit on the nurses’ campaign last year, while teaching in Montana, and was impressed by its scale as well as the support it enjoyed in a deeply conservative, Republican community. The nurses also have an expansive vision: they hope to eventually form a wall-to-wall, industrial union that would include all white- and blue-collar workers in their hospital network, something unheard of in the state.
May Julie and her coworkers win big!
Thanks for reading,
Tammy
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Related reads and listens:
When Julie and her colleagues returned to contract talks after their strike
Kalispell nurses as an object lesson in staffing shortages
How union workers defeated a recent right-to-work push in Montana
Andy’s recent interview with Gabriel Winant about the history of organizing in health care
In one of our earliest episodes, during the worst of the pandemic, a talk with New York nurse and organizer Tre Kwon
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E. Tammy Kim: How long have you been a nurse, Julie?
Julie Anderson: I’ve been a nurse for twenty-four years, and I’ve done all sorts of nursing. I have been in Montana since, like, 1980, and then I went up to Portland, Oregon for nine years and worked there and then came back home. I’ve been up here in Kalispell for almost nine years.
ETK: For people who don’t know, Kalispell is right by Glacier National Park. It’s a beautiful part of the state. And you work at what used to be called Kalispell Regional Healthcare (KRH) and is now called Logan Health. What is your job there?
JA: I am a primary-care navigator in the clinic. I call patients after they’re discharged from the hospital to make sure they have all their medications, all their equipment, to get any questions answered, and make their follow-up appointments. I do a lot of community-resource finding: rides and insurance, things like that.
ETK: What kinds of patients do you see in terms of income, race, and what they’re going to the hospital for?
JA: We have a predominantly white population up here. We have a lot of people who come here for the summer but live in, say, Arizona or Hawaii for the winters—what we call “snowbirds.” We have a lot of elderly. There’s also a tough-guy mentality up here: that you don't go to the doctor unless you're really sick. We have two main reservations close to Kalispell, the Flathead and the Blackfeet, so we have a lot of Native American population that comes. A lot of them are transferred to our hospital or come to our hospital because their hospitals are smaller.
ETK: Montana is a conservative state in some ways, but it’s not a “right to work” state yet. Have you ever been part of a healthcare union or nurses’ union in Montana?
JA: Yes, my hospital down in Missoula, St. Patrick Hospital—they’re union. And I worked at Community Medical Center, the other hospital, but only as a CNA (certified nursing assistant), when I was in nursing school. So I believe they have a union too, but I wasn’t part of that. Both of those unions are with Montana Nurses Association, and they only unionize nurses.
ETK: What difference did it make to be in a nurses’ union in Missoula versus in Kalispell, where you were not in a union?
JA: The union brings a lot more of a voice for nurses and better staffing and wages. We’re behind in the state of Montana in all of those things, and I think that when we get our contract settled, there will be improvement. [The hospital] already improved the wages of our coworkers that aren’t nurses, so just having our union being voted in has seemed to have raised the wages for others, which we’re very pleased about.
ETK: When did you guys decide to form a union?
JA: I heard that this was either the third or fourth time that the nurses here in Kalispell have tried to unionize since the beginning of the hospital, and this campaign was the only one that was successful. In 2018, KRH paid a $24 million settlement for allegedly defrauding Medicare and Medicaid by giving kickbacks to physicians. We felt that our little community hospital no longer had the community’s best interests at heart. Then, a few years ago, there was a significant restructuring of the nursing department, where management eliminated our charge nurses. They also increased patient ratios in some nursing units, too.
All of those nurses’ jobs were eliminated, and they had to scramble and apply for a smaller amount of jobs. These were some of our most experienced nurses. Some of them were not offered another position. It was right during the holidays, between Thanksgiving & Christmas. It was a frightening time, and we didn’t have any say in all of the changes. Lastly, if you were disciplined or fired, there was no one to help you and no recourse to get your job back. There was no grievance procedure.
ETK: So what did organizing look like? When you decide you want to have a union, it’s up to the workers, obviously, just to come together and say, “We are now the union.” But sometimes workers reach out to union organizers at an established union for help. How did you figure out which union you wanted to go to?
JA: We met secretly because of fear of retaliation. And we interviewed [unions]. We had the Teamsters come out, the Montana Nurses Association, and then we also called SEIU. Then we had a few meetings, and there was a vote on who the nurses wanted to have be our union. And everyone voted for SEIU, mostly because, not only are they a strong union, but they’re also a union that supports other staff that we work with, and then the other staff can choose to unionize also, if they want to. They have an opportunity to.
ETK: Why was that important to you: that non-nurses could be part of the same union as you guys?
JA: Just for fairness, if the same things that happened to us happen to them. They also need a voice and fair wages.
ETK: When you started meeting in secret, were you meeting just with other nurses, or were you guys also meeting with janitors and receptionists?
JA: We didn’t reach out to the other workers until after we got our vote in. And then, we started inviting them and letting them know information and how it’s going.
ETK: For somebody who hasn’t been through a union election before, let’s describe it a little bit. Usually there is a conference-room setup that’s in the workplace or somewhere very close by, and all of the workers come in to do a physical secret-ballot election, right?
JA: We actually borrowed the space from my local church here—they have a big gymnasium—and so we held the election there. And it was all secret ballot, and everyone had to come and sign in and vote. And then the votes were counted at the hospital, in a big conference room, in front of hundreds of people. I think the first few votes were “no,” and it was very nerve-wracking. But then the majority of the votes were “yes,” and we won by overwhelming majority. We were so excited and elated.
ETK: I think a lot more people now have imagined that process because of the Amazon union in Bessemer, Alabama, which got a lot of press. People were reading about how Amazon was trying to defeat the union and trying to intimidate workers to vote against the union. Did the employers at Logan Health try to intimidate you guys or convince you to vote “no”?
JA: When we did the vote, they did. They had a Q&A and FAQ on the intranet of our hospital about labor unions. “We don’t feel like you need a union, because then you can’t talk to us directly.” “Give the new CEO one more year, one year to try to change things”—because we got a new CEO shortly before we formed the union. And they also put news articles that weren’t favorable to unions on the website.
Currently, management has anti-union posters posted all over the hospital and clinics, on our intranet for work, and also on the hospital’s Facebook page. There was also a non-nurse manager of supplies and materials who is calling our nurses’ union “terrorists” on her Facebook page and, I heard, to some nurses’ faces because the Teamster UPS delivery drivers wouldn’t cross our picket line to give her supplies.
ETK: Did they ever pull you into a meeting to try to say, “Hey, we’ll give you a raise” or “We’ll be better—just give us a chance”?
JA: Well, they had a big open forum and were trying to talk about great things to come: this great vision, with the new CEO, that we’d have transparency with management, and that they were going to have a “voice box.” We could put our comments into this box, and they would be addressed weekly by a committee, and then we would get to know the outcome of our concerns. They did this whole voice initiative, they made all of their employees take an hourlong class about how they’re going to hear our voice and how great it’s going to be and just how much more communication and good work we’ll do together. The promise of transparency and the voice box went away within months.
ETK: How did you convince workers who did not want the union that they should vote “yes”?
JA: You just kind of ask them. A lot of nurses that have worked here, this is their only place of employment, their whole career. So if it’s always been normal, then maybe you don’t know that it could be better or different. There’s a culture of fear here, because the hospital owns almost all of the health care places in town, and there’s just a handful of places that you can go to if you don’t work for Logan Health. So we would say, “You need a voice. Do you want a voice? Do you want adequate wages that are comparable to other hospitals in Montana? Do we want to try to improve staffing?” All those things that we’re concerned about?
Throughout the whole campaign, we still reiterate what we’re fighting for and what the benefits would be, so there’s been a lot, a lot of communication. And it’s been really hard with COVID, as you probably know, because we were not seeing each other very much. We weren’t in meetings together anymore. So we really had to do word of mouth and a lot of phone calls. Quite a few of our staff got COVID.
ETK: I guess it’s a challenge for you guys to continuously organize. When your unit is over six hundred nurses, how do you keep those lines of communication open? Do you guys have a phone tree? Do you have a list of twenty people to reach out to on a daily basis? How do you keep those channels of communication open with so many people?
JA: A few people asked about it: what’s their plan, and what are they fighting for? Why are they fighting so hard against it? So there’s a lot of talking with our nurses. We were elected bargaining team members, and we pretty much got a person from every department. And then we have our CAT team, a communication action team. We like to have a text chain with people in our department, so then if people need help, we’ll take a list of people to call or touch base with or just be there to answer questions. We also have bulletins that we send out with updates and quotes from all the different nurses about what the fight is for what we’re trying to gain, and that we’re hopeful that we’ll get our contract. We also get actual printed bulletins and put them up in all our areas, on bulletin boards on all the floors and all the clinics. At this almost two-year point, we’ve got it down. We answer a lot of questions, and if there are questions that we don't know, then we have our organizer, Ronnie [from SEIU], who’s here, who can help with the real detailed questions.
ETK: I have heard that even though you guys do have majority support, that there are some nurses who are not so excited about the union, can you tell me about that?
JA: There’s just a small group of nurses who don’t want the union. And so they have been actively trying to collect signatures from nurses to try to decertify our union. And what that means is, they want to vote the union out. It would just be like, exactly how we voted it in, but in reverse.
ETK: How many people are involved in this?
JA: I know of three nurses that are very vocal about it on their websites and Facebook, but I don’t really know how many they are. They filed a petition to decertify with the NLRB (National Labor Relations Board), and you need thirty per cent to call for that and do the vote. So they told the press and everyone else that they already had forty per cent of signatures, and they filed June 1, when we had our strike. Just the other day, the NLRB decided they didn’t have enough signatures, so they withdrew the petition. They not only didn't have forty per cent, they didn't even have thirty per cent of the vote. They are still actively trying to get signatures, and they said they’ll refile. They really don’t have a plan. With management, they just want to have the union out.
ETK: So you guys formed a union about two years ago, in June of 2019. When did you start bargaining a contract?
JA: I believe it was November of 2019, wow. And I think we had a couple [sessions] every week and then every other week, and then COVID came and we went to Zoom. We are still Zoom bargaining now.
ETK: How did your work change during COVID? How bad was the pandemic where you were, and did you have colleagues who were affected by the virus?
JA: In March, when it happened, the hospital created a COVID command center. They had a bunch of managers and administration make a big COVID committee and, of course, it was ever-evolving because the whole virus was evolving. We cut down appointment times and did a lot more tele-health, and they stopped elective procedures for a while. Then, during that time, they also furloughed six hundred twenty-five staff and nurses across the board.
We have a few [staff] that were sick and have long-term COVID symptoms. The virus is so crazy, because it just affects everybody so differently, and you really don’t know how it’s gonna affect you until you get it.
ETK: So it’s the spring of 2020, and you guys are dealing with COVID, obviously. And at the same time, you’re still trying to bargain your contract over Zoom. How far did you guys get?
JA: Before [COVID], we could be in the room with them and talk back and forth and give them our stories, give them examples of what’s happening. And with Zoom, we can’t really talk back and forth very well. We did get a federal mediator to mediate bargaining for quite some time now.
We’re making progress, but it’s very slow. We are still are getting tentative agreements (preliminarily settled contract provisions), but management hasn’t been moving much on wages, staffing, and benefits. We felt like they're not bargaining in good faith, so we filed numerous unfair labor practice charges against them. We couldn’t get anything in writing for a while, and they had their own proposal documents instead of going back and forth with one document. And they just seemed like they were done bargaining—a “We’ll give you more dates”-type of thing. We were bargaining quite frequently, and then they went down to one or two a month.
So it was April or May that we had a strike vote. Just like the regular vote, you came to the church gymnasium again and did a secret ballot. We had a super huge majority of yeses and a very small amount of no’s for the strike. After that was a lot of talking to our nurses and explaining everything, because nurses love their patients and want to help people. And so the thought of a strike and leaving our patients… no nurse took wanting to strike lightly. I mean, it was probably one of the hardest decisions any of them have made.
After the strike vote, we actually did bargain one or two times. We bargained until almost 2 a.m., and management walked away from the table. Management said, “We’re done.” And then from that day, we gave a ten-day strike notice, the exact dates and times the strike starts and ends so they could find coverage. All during that ten days, we told them we would meet with them every day, we would stay all day and all night, we would do whatever it took to get a contract to avoid the strike, and they declined.
ETK: What day did you guys walk out, and what did that look like, with so many hundreds of nurses?
JA: June 1, at seven o’clock, everyone that was working walked out of the hospital together and then met the rest of us outside. It was in front of the hospital, on the sidewalk. That was the first strike. We had strike lines, picket lines—one right in front of the hospital, then one at the highway, which is maybe five or six blocks from the main hospital. And we also had nurses and other unions from all over our community come and support us: the teachers’ union, the firefighters’ union, the electricians’ union, AFL-CIO.
Before the strike, we had sticker-ups and community petitions where thousands of community members signed in support for us, and we put it in the paper. We have yard signs that say “patients before profits” and “we support KRH nurses.” So we’ve really done a lot of things, but the strike was the biggest tool in the toolbox.
ETK: Were there any people who are in your union but were somewhat skeptical, or not that active in organizing, who showed up?
JA: There were a lot of nurses. Quite a few of us are bargaining every time, and just to see nurses who aren’t active still support us was amazing. A lot of them say, “Oh, we trust you. We know you know what you’re doing, and you’re doing what’s best for us.” Just getting to meet them and knowing how many hundreds of them support the union was great, because sometimes it can feel like the bargaining team are the only ones constantly working, but there’s so many nurses that support us silently, and they do talk to their co-workers, too. A lot of people are still afraid of retaliation, and so they support quietly, but they were there in droves.
ETK: You guys were on the strike line for how many days?
JA: For three days, and then at the end of the three days, we had a big rally down at Depot Park, which is downtown in Kalispell, probably a mile away from the hospital. We had a ton of community members and a bunch of other union speakers come and talk. We got so much community support. It united us and energized us as a group. I mean, when you’re a nurse, where you work and who you work with is pretty much all you know, so it was really great to meet all these nurses from all across our hospital and all of our clinics coming together for the greater good—to try to have a voice in staffing, wages, and patient care.
ETK: Did it force management to come back to the table and to give you guys what you want?
JA: Well, they came back to bargaining, and we got some more tentative agreements. It wasn’t really big movement, but we still are making progress. We just had bargaining this week, and we got seven more tentative agreements, and they did move on the wage scale.
I think the strike made them realize that there was a huge majority of us that did attend the strike and picket. I think they realize how many of us want the union, want to keep the union, and are part of the union—and are the union. And so they didn’t do a lockout… they welcomed us back to work on that Friday morning.
ETK: What do you think this effort has meant to the community? It’s a relatively conservative community that might not like unions, so how are you convincing people who might be skeptical to come out to support you guys?
JA: We have a lot of blue-collar workers here, and there are strong, strong unions. Their families understand how important unions are, and generations that believe in unions are all here. In the community, nurses are the number one trusted profession, and it’s been like that for quite a few years. They want us nurses to have good working conditions and a living wage. With the pandemic, thousands of people moved here, and so our cost of living has really skyrocketed, and there’s nowhere to live. There’s nothing to rent, and houses are being sold very quickly. It’s probably been like this in a lot of the bigger cities for a long time.
ETK: Even though [housing] doesn’t directly relate to the workplace, that’s something that’s on your minds, I assume, when you’re talking about pay?
JA: Yeah, our wages, unfortunately, are really low. We don’t have a transparent wage scale. We don’t know how much each other makes. When you talk to nurses, some make five, ten dollars more an hour, or less, than you. It's a pretty big range. We're between the Libby, Montana hospital and Cut Bank, Montana hospital—Libby is a twenty-five-bed hospital. There’s only two thousand, seven hundred people in that town. And then Cut Bank is twenty-bed hospital, and they have three thousand people in the town. I think Logan is two hundred twenty beds. We have, within the Flathead Valley, one hundred thousand people. We’re a premier hospital, and then our wages are in between these tiny, tiny hospitals.
ETK: When you say that there’s a long union history and people get that this makes life better for your family, do you think that goes for whether people are Democrats or Republicans? I know that in Montana recently, there was an attempt by the Republicans to make the state right-to-work, but that failed. Is this a partisan issue?
JA: Even though we had a Democratic governor for a long time, besides Missoula, it’s a pretty red state. The Republicans were doing that big push to right-to-work and tried to get us to sign it. An anti-union nurse sent an email out at work to get us to sign it. And basically, all of the unions went to Helena, our capital, and hundreds and hundreds of them went to try to get that bill defeated—and it was defeated. We let our members know what it was about, because right-to-work sounds like it’s really great.
ETK: I think that kind of working-class dynamic across political lines in the state seems very unique. Moving forward, what do you forecast as you guys proceed in bargaining?
JA: Our goal is to get our contract signed. We’ve never had a goal to strike. We’re really hopeful we’re gonna get this completed in a short time. We have a lot of tentative agreements. Of course, we’re still fighting pretty hard for the staffing and wages. Anything connected to money is, of course, harder than the rest.
ETK: In the grand scheme of things, why do you think this campaign is important? Does it set any example for other workers in Montana or the country?
JA: There’s never been a union here [in this hospital], and we finally got one in. It just shows that people want a voice, and people want choices. The nurses that work in the hospital are on the front line and are taking care of patients, and they know exactly what patients need.
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