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U.Va. Health workers begin to unionize against top-down management, inadequate staffing and subpar wages

United Campus Workers of Virginia sent a survey to all employees of U.Va. Health in order to better understand hospital workplace conditions

The press release is the first public attempt by the union to increase its membership of hospital employees.
The press release is the first public attempt by the union to increase its membership of hospital employees.

United Campus Workers of Virginia at U.Va. — a union open to anyone who receives a paycheck from the University, including students, medical employees, faculty and staff — published a press release Nov. 12 calling for the unionization of hospital employees. According to the press release, the union is seeking to organize hospital workers due to reasons such as “top-down approaches to management, inadequate staffing and subpar wages.”

The press release is the first public attempt by the union to increase its membership of hospital employees. 

A patient care technician at the University Hospital, who asked to remain anonymous, cited the importance of joining a labor union in order to create better working conditions. 

“I feel very strongly that hospital workers and all workers at U.Va. need a legal entity through which we can collectively push back on leadership and gain more power for ourselves and more say in how our workplaces are run,” they said. 

An email was sent by UCWVA-U.Va. to around 5,000 U.Va. Health employees Friday and Saturday, asking them to fill out a workplace survey sharing their experiences working in the health system. 

Workers were asked to what extent they were confident that their health insurance and workplace could provide them with care and support if they got sick, as well as if they could afford the bills under their current health insurance plan. They were also asked about the frequency in which they encounter unsafe circumstances for themselves and patients while working — both before and during the pandemic. 

Additionally, the survey asked workers to what extent they agreed with the statements that they were not fairly compensated for their jobs, were assigned more work than they could safely do and would like more say in decision-making. Workers could also describe any instances of discrimination they had faced at the workplace and whether they were comfortable reporting these incidents.

According to the patient care technician, problems in the hospital workplace are systemic but have been made worse in the context of the pandemic. 

“We were already a slightly understaffed hospital and we became a very understaffed hospital,” he said. “There have been decisions made about how to handle the staffing situation during this pandemic that were made by upper management without much input from the frontline workers who actually have to deal with the working conditions.” 

The patient care technician mentioned that the University Health System currently has a staffing shortage that has resulted from financial struggles during the pandemic. Nurse-to-patient ratios vary from unit to unit in the hospital and differ from week to week. According to the patient care technician, ratios should ideally stand at 2:1 in the ICU, 3:1 in intermediate care and 4:1 in acute care. During the pandemic, however, nurses have had to care for five or six patients in acute care units, which used to be a rare occurrence. 

In April, the health system reported an $85 million deficit per month as surgeries and clinical visits declined by 70 percent and 90 percent, respectively, leading to salary reductions for hospital leadership and furloughs of hospital employees in order for the hospital to secure financial stability. These financial mitigation measures ended in July, but the repercussions are still felt by hospital workers. 

Eric Swensen, Public Information Officer of the University Health System, provided a statement on behalf of the health system indicating their commitment to ensuring the safety of their employees. 

“The University values the input of our employee community and we have engaged stakeholders from across the University and broader communities throughout the Return to Grounds process,” Swensen said in an email to The Cavalier Daily. “We recognize the tremendous challenge the pandemic has posed for U.Va. Health and its valued employees and we continue to work with them to address their concerns. The safety of every member of our community remains our highest priority.” 

According to the patient care technician, U.Va. Health is currently hiring a few hundred nurses in order to address the staffing shortages, but he wonders if their actions will be good enough to ensure staffing stability in the long term. 

Ida Hoequist, a graduate student in the department of anthropology, is part of the committee that released the survey. The survey’s two primary goals were to identify hospital worker issues and build worker power, namely for hospital workers to express inadequacies in the workplace and have a way to get in touch with the union and each other to build collective strength.  

Despite being on the committee, Hoequist was not involved in creating the survey questions. The survey resulted from several months of effort and was written entirely by hospital workers who identified the need for a survey in the first place. 

“That’s UCWVA’s mission of how [workplaces] should run in a nutshell,” Hoequist said. “The people directly affected by decisions should be the ones who make [them], whether that’s as simple as what goes on the survey or as huge as staffing shortages at the hospital.”

Three hospital workers were on the team that created the survey. One of them, who asked to remain anonymous, works at a clinic helping with patient access, which involves scheduling, doing paperwork and checking patients in and out. In making the survey, she used her own experiences as well as concerns they heard from their coworkers in order to come up with questions that everyone would have an opinion on. 

Beyond staffing shortages, the patient access worker was particularly concerned about a new absenteeism policy implemented early in the year that applied to all health system employees. Previously, all absences and tardies throughout the year were cleared on Jan. 1, but now they accumulate. Employees can have up to five tardies and five absences before receiving a write-up. If they go 180 days without absences and tardies — the two being counted separately — they can effectively “drop” one of their accumulated absences. 

According to the worker, the only excusable reasons for being absent are testing positive for COVID-19, a handful of other infectious diseases and diarrhea. 

“I just thought this policy was obviously very top down,” the patient access worker said. “There was no consultation with the actual people who have to abide by this policy. If there’s a problem with absenteeism, maybe [management] could look into why. Maybe [they] could ask. Maybe we could work together to find a solution that works for everybody.” 

The patient access worker was also worried about employee burnout, which had existed prior to the pandemic but had only worsened due to increased stress about wearing PPE and potential exposure to the virus. Additionally, due to patient privacy, if one of her coworkers tests positive for COVID, she isn’t informed. She believes that some kind of notification system is necessary to protect employees from exposure. 

Hoequist expressed that a lot of the concerns brought up by workers predate COVID-19, and that these existing inequities have only been highlighted and exacerbated by the pandemic. 

“In a way, I want to say the pandemic makes everything sharper and feel more urgent, but it hasn’t so much created problems as worsened what’s already there,” Hoequist said. 

Currently, the union has over 100 members, with only around 10 of those members being hospital workers. The University employs nearly 30,000 people, around 12,000 of which are health system employees. 

For many hospital workers, a union is a forum to connect with others who share similar experiences and a way to have a voice in addressing collective concerns about the workplace. 

“I can't think of anyone who doesn't have a decent work ethic that I work with,” the anonymous patient access representative said. “I wish management would trust us more to do what’s right, but also take care of ourselves. That’s why I think we just really need a voice. If there’s an issue, let’s get together and talk about it and see how we can resolve it in a way where everybody is happy — management, workers, and patients.”