How River Hills health care workers won their union in Iowa

Health care workers aren’t largely unionized across the country. But that’s now changing: In Iowa, a second hospital system’s workers have unionized. Here’s how they did it.

Logan Thomas, a nurse at River Hills Community Health Center in Ottumwa, saw the news of thousands of nurses at UnityPoint hospitals in Des Moines unionizing over working conditions, and knew he wanted to try at his workplace—even though he’d never been part of a union before.

“There’s a lot of unheard  issues,  a lot of  pretend listening that happened for a long time,  until  it finally drove us to the point in January where I decided  I’d  try to  unionize and just see how much interest there was,” said Logan Thomas, a nurse at River Hills Community Health Center in Ottumwa. “And there was a lot right away.”

Health care workers largely aren’t unionized. And that, says Teamsters Local 90 organizer Nico  Hernandez, is because they’re accustomed to thinking of others.

“People have been accultured to,  especially in the healthcare industry,  to just push down what they’re feeling because they’re told that they have to be martyrs,  that they  don’t deserve to have safe working conditions,” Hernandez said. “That this is healthcare, this is just the way things are.”

But after the COVID-19 pandemic, when frustrations boiled over, workers began getting assaulted, and some saw their bosses turn a blind eye to their increased workloads. That made workers like Thomas start talking to one another about what they wanted from managers.

“More transparency, more fairness and clear expectations” were some of the main issues he heard. “These are more simple things that you would think that you could get without a union, but unfortunately it didn’t seem like that was the case.”

He also heard workers wanted a better time-off system, and more affordable health insurance.

“It’s especially ironic being that we are healthcare workers and we have such expensive health insurance,” Thomas said.

So Thomas went to work, unionizing all workers—not just nurses—at all River Hills locations, not just in Ottumwa.

He said he loved getting to know everyone. But his bosses didn’t make it easy.

“Met a ton  of resistance from admin and management—highly  coordinated,” Thomas said. “And  lots of  outside contractors that were very well paid.”

But that didn’t stop him. More than a year later, River Hills workers voted for a union—and after five ballots were challenged, 45 full- and part-time workers won their union, 27-19, and will be represented by Teamsters Local 90.

“It was hugely exciting,” Thomas said of the result. “I mean,  the day that we had the vote, we really wanted to know then. Unfortunately, it took some deliberation.  But it’s still exciting.”

But their new River Hills United union is just getting started. Now, they’ll have help bargaining their first contract with Hernandez and Teamsters Local 90, which is also working on UnityPoint’s first contract.

“Healthcare workers deserve to have dignity on the job. They deserve to have fair pay. They deserve to have respect.  They deserve to have their voices taken seriously,” Hernandez said. “ And that hasn’t been happening—not just at River Hills, but at institutions across Iowa.”

Hernandez said other workers in Iowa health care have also reached out for help unionizing, and recommended people talk to their coworkers as well as contacting their local union for help.

“UnityPoint was a big inspiration for us here,  and I hope  just more and more healthcare union wins across Iowa—especially since ours is different from UnityPoint, it’s not just nurses—can inspire people  to unionize their workplace,” Thomas said.

“It’s wonderful to be united with your coworkers  and to be able to talk to them directly and to have such  clear communication,” he added. “So what I hope is that this will lead to more and more  workplaces  having better  worker rights.”

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