Maine Medical Center in Portland, where management is fighting an attempt to unionize by nurses who will vote next month on whether to join the Maine State Nurses Association. (Portland Phoenix/Jim Neuger)
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Maine’s biggest labor organizing battle in a generation is underway at Maine Medical Center, as the Maine State Nurses Association tries to convince more than 1,600 nurses to certify a union amid determined opposition from MMC management and its parent company, MaineHealth.

The stakes are high at the Portland hospital, Maine’s only Level 1 trauma care center. The unionization campaign follows unsuccessful efforts in 1976 and 2000, as well as smaller, more recent organizing battles elsewhere in the state, as the union tries to establish a foothold in southern Maine. All of the eight hospitals where nurses are organized are in northern and eastern Maine.

If the campaign is successful, MSNA would nearly double its membership, which now stands at 2,000, with about half employed by Eastern Maine Medical Center in Bangor and its parent company, Northern Light Health.

Maine Medical Center’s resistance has already ignited controversy. An internal memo to the nursing staff from Chief Nursing Officer Devin Carr, first reported by WMTW, said all nurses would be required to attend “training” where management would present “factual information about your legal rights.”

Carr went on to blame union organizers for having to employ this strategy. “Nurses will have to step away from caring for their patients and staffing vaccine clinics and testing centers in order to attend this training,” he said. “This is the kind of divisiveness a union brings to the workplace.”

The hospital later claimed the sessions were optional, but the themes of Carr’s memo have continued in other presentations.

In a four-minute video sent to nurses from the hospital chief executive, Jeff Sanders, soft music plays in the background as Sanders, who became CEO a decade ago, talks about his childhood surgeries in Portland and his desire to give back.

University of Southern Maine Professor Michael Hillard: Maine Medical Center MMC has “a well-earned reputation for corporate hard-ball stuff.”

But Sanders deliberately employs the phrase “union-free,” and closes with an appeal to “Keep MMC whole.” Other corporate communications refer to the hospital “family” and how a union would be a “third party” interfering with the relationships between management and staff.

Sanders praises staff as “incredibly collaborative,” but acknowledges that in the early days of the pandemic “we had to move our nurses around, and I know how stressful that was.”

Nurses themselves have described working consecutive 12-hour shifts, and how it continues to be difficult to provide care; waits of up to three days for an in-patient bed have recently been reported.

The previous and current union campaigns have given MMC “a well-earned reputation for corporate hard-ball stuff,” according to Michael Hillard, an economics professor at the University of Southern Maine and expert on labor relations.

A new approach

On the other side of the campaign is National Nurses United, a fast-growing union that now has 185,000 members. Based in Sacramento, California, it has eight state affiliates, including Maine – the only one in New England. MSNA President Cokie Giles is also one of four national co-presidents.

Its organizing arm, called National Nurses Organizing Campaign, represents a shift from previous representation through “umbrella” national organizations such as Service Employees International Union, which ran the 2000 campaign (the Maine State Employees Association has been an SEIU affiliate since 1988).

Sector-specific unions have not always been successful, but National Nurses United has an admirer in Matt Schlobohm, the long-time executive director of the Maine AFL-CIO. “They can build a level of knowledge and expertise that is phenomenal,” Schlobohm said.

During the pandemic, he added, there were daily postings on whether, for instance, it was safe for nurses to reuse masks, which hospitals were urging them to do while personal protective equipment remained in short supply.

“Hearing ‘That’s not OK’ from a fellow nurse is incredibly helpful,” Schlobohm said. “There’s a high quality of research and guidance.”

He also said it’s important that other Maine nurses are already union members, because “they can share experiences one-to-one, which is how organizing is being done at the moment,” due to pandemic restrictions.

Cokie Giles is president of the Maine State Nurses Association.

The union is deliberately taking a low-key, no-publicity approach. The only public statement set to appear before the certification vote came from Giles: “We are excited to have registered nurses from Maine Medical Center vote to join Maine State Nurses Association.”

Giles, an endoscopy nurse at Eastern Maine Medical Center whose daughter has also been a nurse at EMMC, has served as co-president of the National Nurses Union since 2013. In 2001, she led the drive to disaffiliate from the American Nurses Association and join the national movement led by the California Nurses Association; NNU was formed in 2009.

The daughter of a Teamsters truck driver, Giles has bargained, and testified at the Legislature, for improved staffing ratios. She said, “there should be a standard of care that everyone is treated adequately and safely.”

Her family provides ample support for her position. An adult son has been diabetic since childhood and, while always employed, has lacked insurance and has been hospitalized repeatedly for lack of routine care.

“That’s why I’m so passionate about single-payer and Medicare for all,” she said.

At a protest in downtown Bangor last August, Giles told reporters, “Nurses and other health-care workers are getting extremely sick while caring for their patients. My heart is heavy when I tell you at least 174 nurses in the U.S. have died of COVID-19.”

MMC tactics

National Nurses United is just coming off a stunning campaign victory in North Carolina – not known as being sympathetic to unions – at Mission Hospital in Asheville. Organizers began work there after the community-based nonprofit sold out to Hospital Corporation of America, the nation’s largest for-profit chain.

According to the union, HCA immediately began cutting staffing levels, eventually producing a strong backlash among staff. In September, nurses voted overwhelmingly, 965-411, to certify a union for about 1,800 nurses, using a mail-in secret ballot authorized by the National Labor Relations Board.

The same pandemic-related procedure will be used in Portland. Ballots will be mailed on March 29 and must be returned by April 27. The ballots will be counted by the NLRB starting April 29. The formal organizing petition was submitted by Maine State Nurses on Jan. 12.

There have been other controversies concerning the hospital’s response, particularly after it was reported by the Portland Press Herald that MaineHealth, contrary to state protocols, had offered COVID-19 vaccinations to all of its 22,000 employees, even those who work at home and have no contact with patients.

Tensions ratcheted up further when it became known that the hospital had also offered the vaccine to employees of Reliant Labor Consultants of Apollo Beach, Fla., a firm specializing in “union avoidance,” which was hired by MMC to help beat back the union effort.

Its detractors refer to this as “union-busting,” and note that one of Reliant’s principals, Joseph Brock, is a former Teamsters local president who performed similar services for Donald Trump’s casinos.

In a video on his website, Brock talks about his experience with the Teamsters: “When I became the president of the union, I came to learn that we were not a social cause fighting greedy corporations, we were a greedy corporation.” 

Only Maine residents are supposed to get the vaccine here, according to state protocols.

That spurred Gov. Janet Mills to action. Earlier she told the Maine Beacon  she had no opinion on the nurses’ organizing campaign “because I really don’t know enough about it and I don’t think it’s my place to tell them what they should and shouldn’t do.”

But Mills was much more direct when the Reliant Labor Consultants vaccinations were disclosed. “It was an insult to the hardworking nurses trying to assert their rights and to those who are waiting patiently for their turn,” she said. “That was an inexcusable act. I am glad (MMC has) recognized their error.”

Pandemic impact

The organizing campaign has received endorsements from many unions, including SEIU, and also from the normally insular Local S6 at Bath Iron Works, which represents the bulk of the shipyard’s more than 5,000 employees.

The BIW union posted on Facebook that “Machinist Local S6 stands with the nurses at Maine Medical Center,” and that “it’s time we blow the whistle on the anti-union corporations that hire lawyers and spend big $$ to intimidate their employees for trying to form a union.”

No one seems willing to offer predictions about how the vote will go, but union observers think the strains of the pandemic on the health-care system at large, and nurses, in particular, could tip the balance.

Michael Hillard points to the student debt loads carried by nurses and other graduates of public institutions that were unheard of a generation ago.

“There is a growing sense of unfairness in our employment system,” he said, “and the realization that we can’t rely just on employers and the market, or we’d be seeing a lot more good jobs, instead of gig work and dead-end service positions.”

He added, “We’re at a point where we’ve had 40 years of in-your-face capitalism, and we’re seeing a greater willingness to organize, especially among young workers.”

Douglas Rooks has covered Maine issues since 1984 as a reporter, editorial writer, columnist, and former editor of Maine Times.

Hospice of Southern Maine in Scarborough, which has ties to MaineHealth. A successful union drive in 2017 was later overturned in a decertification vote. (Portland Phoenix/Jim Neuger)

Union track record at MMC isn’t stellar 

Efforts to organize workers at Maine Medical Center have a long and tangled history, with major campaigns occurring almost a generation apart: first in 1976, then in 2000, and finally this year, with nurses scheduled to vote on affiliation with the Maine State Nurses Association starting March 29.

The 1970s, at a time when public-sector unions were burgeoning, saw a 1974 attempt by the Teamsters to organize the hospital’s maintenance workers, according to Maine labor historian Charles Scontras. That election narrowly rejected the union.

A much more comprehensive effort began the following year, led by the charismatic Boston organizer, Mike Cavanaugh, and the National Hospital and Health Care Employees of New York, Local 1199. An initial meeting of 23 employees was followed by one attracting 325, and the fight was on.

In announcing that campaign, spokeswoman Mary Brennan said “we cannot give patients the quality of care they deserve unless we have a real voice in decisions that affect us as health-care workers and thereby affect our patients.” She said management had ignored employee suggestions for years, and refused to provide health-care benefits for families, or any employee working less than 40 hours weekly.

An administrator with union sympathies who was there at the time said the hospital president, Edward Andrews, and the executive vice president, Donald McDowell, while “nominal Democrats,” were fiercely anti-union.

As in this year’s campaign, the hospital hired several consultants, including one McDowell had known at Vanderbilt University. Other hires, according to Scontras, were Modern Management Methods of Deerfield, Illinois, and “the union-busting legal services” of Morgan, Brown, Kearns, and Joy of Boston.

Local 1199 envisioned five separate bargaining units: for registered nurses, licensed practical nurses, maintenance workers, professionals, and clerical staff. The only vote taken was for the LPNs, who rejected the union in 1976 amid complaints of unfair labor practices; nurses cited specific threats from management about losing hours and shifts.

The National Labor Relations Board ultimately upheld several of the charges, and scheduled a new election for 1977 but it never took place, Scontras said, “because of high turnover and improved working conditions, which the union attributed in part to its activity.”

The 2000 campaign was led by Service Employees International Union for the Maine State Nurses Association, which had successfully organized nurses at Eastern Maine Medical in the early 1970s, before the first Portland campaign.

There were familiar patterns to the hospital’s response. Nurses told of being called into one-on-one meetings with their supervisors, who were then joined by a hospital administrator to detail exactly why joining a union would be a bad idea.

Laurie Haapanen, one of the organizers, said at the time that court decisions barring any similar access by unions wasn’t really a problem: “There’s so little time for nurses on the job, and they’re so stressed, that we prefer to talk to them at home.”

The process for organizing a union requires that 30 percent of employees in a proposed union sign cards requesting an election. If more than 50 percent sign, the NLRB can certify the union without an election, but only with the consent of management, which almost never happens.

Organizers tried to submit far more than 50 percent, knowing that management would whittle down the number of favorable votes. The 2000 Portland campaign followed a similar effort at Central Maine Medical in Lewiston. In both cases, nurses rejected the union, with about 45 percent voting yes in Portland.

The defeat was attributed by organizers, in part, to policy changes pledged by the two hospitals. In Portland, management announced a Nurse Advocate Board to formally hear complaints, although union organizers derided it as a “company union,” something that’s forbidden under federal labor law.

As it happens, there’s a union foothold already within the MaineHealth network, at its Care at Home division. It was formed through the acquisition of several Visiting Nurse associations in southern Maine; one, in Portland, was organized when MaineHealth didn’t challenge the union certification.

A similar process took place in the Bangor area, where many employees of Northern Light’s  Hospice and Home Care division are unionized.

More relevant to this year’s union vote may be a recent battle to organize nurses at Hospice of Southern Maine in Scarborough, which is a “free-standing company,” according to MaineHealth spokesman John Porter, with no financial ties to MaineHealth.

Its most recent 990 filing with the IRS, however, states that the board of directors includes eight members who “have a business relationship with each other through their affiliation with MaineHealth.” Those eight constitute a majority of the 15-member board; one member, Donna DeBlois, is also chief executive of Maine Health Care at Home.

In 2017, the 110 nurses at Hospice of Southern Maine voted to form a bargaining unit in one of the first Maine campaigns led by the National Nurses Organizing Committee. Contract negotiations dragged on, however, and in 2018 nurses who opposed the union petitioned for a decertification election, which rescinded the earlier vote.

Union organizers, as in 1976, cited high turnover as one of the reasons. And reminiscent of the 2000 campaign, they also said that anti-union nurses were paired by management with the new hires during their training and orientation period.

— Douglas Rooks

Matt Schlobohm, executive director of the Maine AFL-CIO: “The public seems aware of the dignity of labor in a new way.”

Organized labor sees opportunity for growth

Union membership made some headlines last month when the U.S. Bureau of Labor Statistics survey reported a one-year increase of 13,000 in Maine, a dramatic increase from 69,000 members in 2019.

The numbers may not be exactly what they seem; the survey has a significant margin of error, and is not based on actual tabulations of union membership. The state Department of Labor once conducted its own survey, but like many hallmarks in the decline of unions, it was discontinued several years ago.

Still, there’s no doubt that there’s been an increase in interest in unions, as well as organizing activity. While it’s too soon to declare a trend, it’s the first substantial upturn in Maine unions’ fortunes in more than three decades.

Matt Schlobohm, executive director of Maine AFL-CIO, said there are at least three key factors.

First, since the U.S. Supreme Court’s 2018 decision in Janus v. AFSCME, which blocked unions from collecting “agency fees” from non-members, Schlobohm said, “there’s been a concerted attempt in public-sector unions to sign up new hires, and to talk to people who’ve never joined.” Maine had permitted such fees since the Baldacci administration.

Second, “unions are strong in what we now call ‘essential’ sectors of the economy,” he said – including jobs in construction and manufacturing, shipbuilding and nursing homes, which all saw substantial hiring during the pandemic.

And finally, there are new organizing campaigns both at companies whose workforces are partly non-union, and those that have never had unions. Most such campaigns are small-scale, and haven’t attracted much statewide attention.

But the Maine State Nurses Association campaign at Maine Medical Center is different. If successful, “that could put things on a whole new level,” he said.

Schlobohm is well-versed in labor history, and he said the union movement has seen peaks and valleys for more than a century, back to a time when strikes were broken up by government-sanctioned violence.

Even into the early years of the Great Depression, “workers were taking action,” he said, “but they were getting crushed.” The New Deal and the Roosevelt administration changed everything.

When the Republican governor of Michigan, Frank Fitzgerald, declined to send in police to break up a 1936 sit-down strike at GM’s Flint manufacturing plant, the United Auto Workers became a major power. The Wagner Act created the National Labor Relations Board and gave workers guarantees against retaliation from employers.

The long decline of manufacturing, and its unions, has driven union membership down to less than half its peak, but such spontaneous movements as Occupy, teacher union activism and Black Lives Matter suggest the climate is changing again, Schlobohm said.

Organizing campaigns at the Preble Street Resource Center in 2019 and now at the Portland Museum of Art have shifted public attitudes as well as those of workers themselves. “You see a much more acute sense of equality, and a bolder set of democratic reforms,” he said.

Another factor is simply seeing that success is possible. “When West Virginia teachers went out on strike (in 2018) it shocked the world,” Schlobohm said. “It changed what people thought was possible.”

The nonprofit sector has seen much of the new organizing campaigns, which include new unions at Maine ACLU, Planned Parenthood, and among Kennebec Valley Community Action Program drivers, along with several city bus systems.

Michael Hillard at the University of Southern Maine said there have been similar developments nationally, spurred by changing perceptions during the coronavirus pandemic. “Even Google and Amazon workers are trying to form unions,” he said. “It feels like we’re in a different moment.” 

Schlobohm agreed. He said “the public seems aware of the dignity of labor in a new way,” realizing that in many workplaces, “we’re calling these workers essential but we’re treating them as disposable, offering low wages and not providing necessary protective equipment.”

Amid the toll taken by the pandemic that sticks in people’s hearts and minds. 

“They understand about the respect and power and material benefits that are missing for so many workers as they risked their lives,” Schlobohm said.

— Douglas Rooks

Nurses and their supporters demonstrate at the Federal Building in Bangor on Aug. 5, 2020, for safe staffing and working conditions. (Courtesy MSNA)

MSNA on uphill climb in southern Maine

When the Maine State Nurses Association began organizing in the early 1970s, it scored early successes at hospitals in eastern Maine that have left it with a solid base of members – more than 2,000, in a state not often friendly to unions, particularly in health care.

Today, it represents registered nurses, licensed practical nurses, and technical and support staff at eight hospitals in Bangor, Millinocket, Houlton, Presque Isle, Calais, Machias, Bar Harbor and Ellsworth, as well as nurses in home care and hospice agencies in Portland and Bangor.

Organizing campaigns in southern Maine have been less successful, but MSNA has expanded its reach by adding employees in other job categories at several hospitals.

When hospitals with organized employees have been acquired by Eastern Maine Medical, which has rebranded as Northern Light, it has sometimes resulted in new campaigns.

An example is the former Maine Coast Memorial Hospital in Ellsworth, where RNs have long had a bargaining unit. Northern Light acquired the hospital in 2015, and in 2017 lab technicians, radiation technologists, respiratory therapists, and LPNs voted to join the union, despite strong resistance from hospital management.

Negotiations for a contract, however, proceeded slowly and last March, the new union members authorized a strike; they finally signed their first contract in August.

Although in many respects a professional association, Maine State Nurses Association has not shied away from more aggressive tactics. In 2010, there was a two-day strike at Eastern Maine Medical Center in Bangor, primarily over staffing levels, sandwiched around a lockout by management. Another strike was authorized, but not conducted, in 2015.

At financially troubled Calais Regional Hospital, which filed for bankruptcy in 2019, nurses authorized a strike last November, with the key demand replacement of the chief executive, Rod Boula, who they said had mismanaged the hospital’s finances.

In a settlement that averted the strike, Boula remained on the job, but nurses won concessions on health insurance and paid time off. 

— Douglas Rooks