Nurses and staff at Oregon’s smallest rural hospital unionize in Morrow County

The Oregon Nurses Association announced Aug. 6 that the nurses and technical support staff at Pioneer Memorial Hospital in Heppner, about 40 miles south of Boardman, are forming a union.

A union organizer said workers are optimistic that they can secure improvements to their working conditions after a state board certified the union. But they’ve already received some pushback from the Morrow County Health District, the public agency that operates the Eastern Oregon hospital.

With 21 beds, Pioneer is the smallest critical care hospital in Oregon. Services mostly focus on the emergency room and long-term care for seniors, serving the nearly 1,300 people living in Heppner and the more sparsely populated south side of Morrow County.

Kathleen Greenup was born at Pioneer Memorial, and after starting a career in health care, she has worked as both an administrator and nurse at the hospital since 2018. She’s now a member of the group organizing labor at the hospital.

Greenup said Pioneer doesn’t deliver babies any more except in emergency situations, nor does it offer many of the services found at other hospitals.

“We don’t have respiratory therapy,” she said. “We don’t have IV therapy. We don’t have EKG technicians. We don’t have hospitalists. It’s just two nurses and two aides (per shift). So it’s super important that those groups of people work very well together.”

When Greenup and her colleagues started discussing unionizing, she said talks revolved around two main issues: staffing levels and the hospital’s disciplinary policies.

Greenup said there are times when there’s only one nurse for the entire hospital, or staff nurses are working with temporary “travel” nurses who are unfamiliar with how the facility operates.

Nurses and tech workers are also subject to inconsistent and overly harsh discipline, Greenup said, with supervisors handling situations with the “intent to discipline and not with the intent to understand.”

“They make rules up as they go,” she said. “They don’t necessarily follow the policies that are already in place, but when they want to follow a policy, they hold us to the letter of the law. There’s no gray area. There’s no discretion. It’s just black and white to them.”

Greenup said working conditions at Pioneer have led some qualified health care workers in the community to commute well outside of town, rather than work locally. One of the union’s goals would be to reel some of those workers back to Pioneer.

“Because our community is so small, a familiar face when you wind up at the hospital is so incredibly comforting,” she said.

In response to an interview request, the health district sent a statement.

“Pioneer Memorial Hospital looks forward to negotiating a first collective bargaining agreement with the ONA,” it reads, adding that administrators expect to have a positive working relationship with the union.

Pioneer is not the only rural hospital to unionize in recent years. In 2022, medical technical workers at St. Anthony Hospital in Pendleton unionized under the Oregon Nurses Association. Tech workers in the Oregon Federation of Nurses and Health Professionals at St. Charles Medical Center in Bend went on strike over stalled negotiations for their first contract in 2021.

ONA spokesman Kevin Mealy said medical unions continue to grow around the state because the relationship between workers and management is degrading as more hospitals are taken over by corporate chains.

While Pioneer is publicly owned and locally controlled, Mealy said smaller hospitals are still feeling the downwind effects of national trends.

“The strain of COVID, the challenges of a national nursing shortage, the new challenges of the job that have grown worse — including workplace violence, including a lack of respect and trust in the medical field – have certainly trickled down and led to more independent, rural hospitals.”

Pioneer nurses and workers delivered a declaration to hospital management demanding to be recognized in March. But before certification, Pioneer’s administration filed an appeal with the Oregon Employment Relations Board, a group that resolves labor disputes and representation matters between employers and unions.

Administrators objected to the inclusion of per diem nurses and tech workers in the union. The hospital has positions for eight full-time nurses, two part-time nurses, and four radiology and lab technicians. Pioneer also maintains a pool of a few dozen “per diem” nurses and techs that are hired for shifts as needed.

The workers argued that per diem staff performed all the duties of full-time staff during their shifts and should be represented by the union. The employment relations board agreed and ruled in favor of the workers and certified the Oregon Nurses Association as the union’s representative.

In addition to the hospital, the Morrow County Health District also operates several clinics and an ambulance service. The latter has put the health district in the headlines over a conflict with a fire district over covering the Boardman area.

The dispute resulted in a lawsuit and was a contributing factor to two separate Morrow County recall elections, one in 2022 and another last month.

Although the new union wouldn’t cover ambulance workers, Greenup said the “debacle” still affects prospective members. When not responding to calls, Greenup said ambulance staff work in the hospital’s emergency rooms. She added that the uncertainty surrounding the health district’s ambulance service led many health care workers to resign.

With the union now certified, Greenup said they were optimistic about eventually coming to an agreement and using the new worker protections to recruit new hospital staff.