Yes, nurse leaders were responsible for driving the change. This is one of the many examples of why two-way communication without having to go through an outside party is so critical to creating a work environment that our nurses enjoy working in. The progress we’ve made across MedStar Health toward consistent staffing rendered the pilot program unnecessary, and it was discontinued in 2024; however, we will continue to explore innovative workflows and new technologies to enhance our patient care and support our nurse associates. These decisions are driven by our teams on the front lines. You understand the challenges and needs of our patients best, and your leaders are in the best position to turn your feedback and ideas into action. It’s a common tactic for unions to take credit for actions and decisions that turn out to be popular with nurses, even when they had no hand in making them.
You ask, we answer! Submit your question here.
March 28, 2025
Would joining a union guarantee a pay increase?
No. Joining a union would not guarantee a pay increase. The law is clear that in bargaining, nurses may end up with wages that are the same, more or less than they had before unionizing. There are no guarantees. It is also true that at MGUH is and has been committed to keeping our nurses’ salaries competitive, with annual increases and off-cycle market reviews and adjustments when needed. In fact, since July 2023, nurses at MGUH have been eligible for 4.5% annual merit increases, plus market adjustments, compared to a maximum of 4% annual pay increase the union negotiated for its unionized nurses at MWHC in 2023.
What is MGUH’s plan for pay increases for highly experienced nurses?
Many of our nurses have been with us for decades – this is a testament to the relationships we’ve built, the career advancement we provide, and our supportive hospital culture. We understand that to retain skilled and compassionate nurses, we must provide competitive salaries and career advancement opportunities. This is why we offer annual across-the-board merit increases and off-cycle market adjustments to ensure we’re compensating our nurses fairly. Plus, our Clinical Advancement Program provides a career ladder and significant pay increases – 5% for Clinical Nurse III and 11% for Clinical Nurse IV.
Can the union guarantee more effective security measures than we currently have?
No. First and foremost, the safety and well-being of our employees, patients, and visitors is our highest priority. No union cares more about our people than we do. That’s why over the last year we have empowered our Workplace Violence Prevention Committee to implement significant improvements to protect our nurses. These improvements include installation of the Evolve Metal Detection system and added security personnel in our ED, new wanding protocols, and regular workplace violence drills. As leaders on the ground, we believe that we’re best positioned to work directly with our associates to identify needs and develop solutions to improve our security measures.
Why are some of my colleagues who previously worked at a unionized hospital concerned about seeing union organizers here at MGUH?
Deciding whether or not to join a union is a big decision that affects all aspects of your job, including pay, benefits, culture, and flexibility. Many of our nurses who have worked in unionized hospitals have voiced their concerns about how it affected their work and personal life. They have shared their experiences of paying dues and receiving little benefit in return. And some have shared concerns about the general negativity they experienced in a unionized environment. If you have concerns about unionization, you’re not alone. Your opinion matters, and you have the right to talk with your coworkers and leaders about how you feel about unionization and why.
A lot of us do not want a union here. Why doesn’t the hospital just tell them to leave?
Union organizers have the right to be on public property. This includes public sidewalks, public parking garages, and on the street. We respect this right in accordance with the law. However, if a union organizer is on hospital property, or is impeding access to the property for associates or patients, we reserve the right to ask them to leave. Please contact hospital security if you see an organizer inside the building or otherwise on private property attempting to disrupt our work. Hospital security can also provide clear direction on what is considered public and private property. MGUH’s standardized hospital policies and procedures regarding visitor access, patient admission, and the presence of non-patient individuals help ensure the health, wellbeing, and safety of our patients and associates.
March 21, 2025
I haven’t seen any organizers or heard much about a union. Why are we talking about unionization?
We’d rather not have to talk about unionization, either. But unionization is such an important topic that when we hear that organizers are starting to talk with a few nurses, it is our responsibility to provide facts about what unionization means. We’re proud of our collaborative culture and believe the best way to foster teamwork and inspire growth is by continuing to work together, side-by-side as one team. We care about our nurses and deeply value open, honest communication. That’s why we are committed to ensuring you have support and resources when it comes to major decisions that could affect you and your family.
The flyer that a union organizer handed me said that all MedStar nurses were uniting with NNU. Is that true?
No. Union organizers often target organizations and make it seem like the employees asked them to be there. In reality, what we’ve heard from most of our nurses is that they aren’t even aware of what NNU is, or that they wish the union organizers would leave them alone. All associates have the right to talk to – or not talk to – any union organizer. MedStar leadership’s commitment is to share facts to support our nurses and answer honestly any questions you have.
Why is an authorization card, or that online form, such a big deal?
A union authorization card or petition is a legal document. By signing, you are potentially giving the union the sole and exclusive right to speak and act on your behalf when it comes to matters regarding wages, benefits, working conditions and other terms of employment. If the union gets signatures from at least 30% of the employees it’s seeking to represent, it can file a petition with the NLRB for a secret ballot election. And, with enough signatures (more than 50%), the union may be able to become your exclusive representative without an election.
What are my rights if I do or don’t want a union at MedStar?
There’s a lot to consider when it comes to unionization. If organizers are asking you to sign an authorization card, that is a big decision, and one that’s yours alone to make. MedStar Health respects everyone’s right to choose what’s best for them when it comes to unionization. Whether or not you support the union has no impact on your employment here.
Making an informed decision starts with understanding your legal rights when it comes to engaging—or not engaging—with the union. Under the National Labor Relations Act (NLRA), you have the right to:
- Sign, or not sign, a union authorization card or petition
- Participate in, or refuse to participate in, union activity
- Campaign for, or against, the union
What has the union actually done for nurses in the past?
This is a great question to ask union organizers. As you learn more about unionization, consider asking organizers this and other questions. You may want to know if they can guarantee any of their promises, or how much dues its members are required to pay. We encourage you to ask questions of us, and of the union organizers to learn more about what is right for you and your family.
March 14, 2025
What can we do if I or the nurses on my unit don’t want a union?
We’ve heard from some of our nurses who have previously worked in unionized hospitals that they would not want to go back to being in a union. You’re not alone. You have rights when it comes to interacting with union organizers and supporters. You have the right to: tell organizers you are not interested and ask them to leave you alone; to call security if feel unsafe being approached by an organizer; to refuse to participate in a call, visit, or meeting; or to campaign against the union with your coworkers. Your voice matters, and you have the right to talk with your coworkers and leaders about how you feel about unionization and why.
If I signed the online form from the union (the union authorization card) and didn’t realize what it was or have now changed my mind, can I get it back?
If you sign a card and then later change your mind, you have every right to ask for the card back and to tell the union you are taking back your authorization of union representation. You can do this by sending a letter via certified mail to the union’s local office. It is also a good idea to send a copy to the National Labor Relations Board regional office as well, so that they know that you have rescinded the authorization and requested that the card be revoked. Keep a copy for yourself, as well, as NNU may not acknowledge receipt.
NNU Local Office:
8455 Colesville Rd, Suite 1100
Silver Spring, MD 20910
(240) 235-2000
NLRB Regional Office:
Resident Office 05 – Washington, DC1015 Half Street SE
WASHINGTON, DC 20570-0001
Tel: (202) 208-3000
Fax: (202) 208-3013
I don’t want a union, but I’m concerned about staffing. What is MGUH doing to make sure we have enough nurses?
Ensuring we have enough nurses to care for our patients remains a top priority for our hospital. We have made significant progress in reducing turnover and are committed to proactively recruiting top talent. We have added associates focused on recruitment and onboarding for nurses, enhanced use of digital marketing to recruit new associates, and developed new or enhanced existing partnerships with Georgetown University, Catholic University School of Nursing, and the University of Maryland. These efforts are paying off: we increased our total staffing by 179 nurses since July, and just last week, we welcomed 25 new nurses to our team.
We’re also focused on making sure we create a workplace where nurses want to stay through annual pay increases, market increases, referral bonuses, and financial incentives in the Clinical Advancement Program. This spring, we will open a new wellness and relaxation center that was co-designed by many of our nurses. We will continue to prioritize hiring and retaining our skilled associates so that every nursing unit across the hospital is properly and evenly staffed.
I don’t want the union to take my money. Would the union make us pay to join?
Unions come at a cost, requiring a chunk of their members’ paychecks to fund their operations, including overhead, travel, and political donations that serve their own agenda. Union members are obligated to pay monthly dues, usually automatically deducted from your check like an extra tax, and members can be subject to additional assessment fees and even fines if they fail to follow union rules. Even if you choose not to join the union, if your colleagues vote to unionize, you may still be required to pay an agency fee to keep your job. Agency fees are about the same as dues.
I heard that the union is saying they got MedStar to end the pilot program for RN:Tech + Virtual Nurse program at MWHC. Didn’t our nurse leaders have a role in that?
FAQs
Unions 101
What is a union?
A union is an organization that represents employees, serving as a single voice on behalf of a group of employees, and negotiating key aspects of employment for the members it represents, such as pay, benefits, and other terms and conditions of work. However, union representation is not free. Unions are also a business, and like all businesses, require revenue to maintain operations. Unions rely on members (employees) as a primary source of revenue, which is collected in the form of union dues and fees.
Does having a union guarantee better pay and benefits, and other improvements?
Union organizers and supporters might say a lot of things to get your support, but the union is not legally required to deliver on any of the changes it’s promising. Any changes to your pay, benefits, or working conditions would have to be negotiated between the union and MedStar Health. While either side can propose changes, there’s no requirement for the other side to agree to those changes, and neither party can simply demand things during collective bargaining.
Will I get in trouble for talking to union organizers, talking about the union, signing a card or voting for the union?
Absolutely not. Associates are free to talk about the union and take whatever action they want with regard to the union. Please just keep in mind that union discussion and organization should not happen in patient care areas, or while you are supposed to be working.
Am I required to speak with an NNU organizer, either at home or at work?
No. You are not required to speak with union organizers or supporters. If you are not interested in engaging, you have the right to ask them to leave you alone. They are not allowed to speak with you in patient care areas or while you are working. If organizers visit your home, you may treat them like any other salesperson or trespasser and ask them to leave.
Do union organizers get paid?
Yes. Consider union organizers as the union’s sales team, whose job it is to generate new business. Once the union is voted in, union organizers typically hand things off to a representative to negotiate the contract. That person may or may not be aware of what promises were made during the campaign, but either way, they are under no obligation to deliver on any of them.
How do I know whether or not to support the union?
Deciding whether or not you want to be represented by the union is a personal choice. We encourage everyone to do their own research, talk with each other, and ask questions, so you feel confident that you have all the information you need decide what’s best for you.
If the union doesn’t work out for us, can we just get rid of it?
No, you can’t “try out” a union. Once the union is voted in, if you decide you’re not happy with the representation you’re getting, you can’t just get rid of it—you would have to go through the decertification process to remove it.
Decertification is a lengthy and complex process, and one that MedStar Health is not legally allowed to help with. Like the initial organizing effort, you would need signatures from 30% of represented employees in order to file a decertification petition.
Additionally, decertification can only happen at certain times. Employees have to wait one year from the date the election results are certified by the NLRB before they can legally file a petition to try and remove the union. And if a labor contract is reached, you would have to wait an additional three years before attempting to remove the union.
Would having a union affect MedStar Health’s Magnet Status?
When we work collaboratively to achieve Magnet Status, it’s something everyone at MedStar Health is proud of. It’s a reflection of who we are as an organization and a team of caregivers, and demonstrates our team’s commitment to safe, quality patient care and to fostering a collaborative, professional work environment that strives for clinical excellence at all times.
NNU does not support Magnet Status or our shared governance model. Instead, the union believes that models of care promoted by Magnet Status “negatively impact the registered nurse’s ability to exercise independent professional judgement and advocate in the exclusive interest of the patient.”
We don’t agree with that—in fact, we’ve experienced the opposite across our system. From their position, it’s clear that NNU does not share MedStar Health’s priorities, values, and mission, and we do not want a third party undoing what we’ve worked so hard to achieve.
Union Authorization Cards
What is a union authorization card?
A union authorization card or petition is a legal document. By signing, you are potentially giving the union the sole and exclusive right to speak and act on your behalf when it comes to matters regarding wages, benefits, working conditions and other terms of employment. If the union gets signatures from at least 30% of the employees it’s seeking to represent, it can file a petition with the NLRB for a secret ballot election. And, with enough signatures (more than 50%), the union may be able to become your exclusive representative without an election.
What does a union authorization card look like?
A union authorization card can take many forms. It may be just as its name suggests—a paper card. However, it can also look like a petition, sign-in sheet, or a digital form. In fact, “signing” a card can be as easy as clicking a button. The flyers shared by union organizers around MedStar recently are promoting use of an online form, which looks like a simple interest form—it is actually an authorization form.
I was told that I have to submit an online form in order to get more information. Is that true?
No. You do not have to sign anything in order to get more information from the union. Union organizers may tell you that you’re just filling out a quick submission form in order to receive information and updates, but in reality, you may be unknowingly signing an authorization card.
Do I have to sign a union authorization card?
No, you do not have to sign an authorization card. The decision to sign something is completely up to you. You do not have to sign anything in order to ask questions, attend a meeting, or vote in an election, if there is one. And signing an authorization card does not mean you’re obligated to support the union, or vote in favor of the union if there is an election.
I signed a union authorization card, but I changed my mind. Can I get it back?
If you sign a card, or submit the online form, and then later change your mind, you have every right to ask for the card back and to tell the union you are taking back your authorization of union representation. You can do this by sending a letter via certified mail to the union’s local office. It is also a good idea to send a copy to the National Labor Relations Board regional office as well, so that they know that you have rescinded the authorization and requested that the card be revoked. Keep a copy for yourself, as well, as NNU may not acknowledge receipt.
NNU Local Office:
8455 Colesville Rd, Suite 1100
Silver Spring, MD 20910
(240) 235-2000
NLRB Regional Office:
Resident Office 05 – Washington, DC1015 Half Street SE
WASHINGTON, DC 20570-0001
Tel: (202) 208-3000
Fax: (202) 208-3013
Collective Bargaining
What is collective bargaining?
Collective bargaining is the back-and-forth negotiation process between a union and employer to try and reach an agreement on a labor contract, also known as a collective bargaining agreement.
How long does collective bargaining take?
It takes an average of 528 days to reach a first-time labor contract in healthcare, according to a Bloomberg Law analysis. During this period, employers are required to maintain the status quo, meaning they cannot make unilateral changes to pay, benefits, or other terms and conditions of your employment.
What topics are negotiated during collective bargaining?
The only topics that must be bargained (referred to as mandatory subjects of bargaining) are pay, benefits and terms and conditions of employment, which are things like working hours, seniority, scheduling practices, promotions, transfers and grievances.
Things that are not mandatory subjects of bargaining include safety protocols, patient care procedures, equipment and supplies, number of employees hired, promoted or discharged, the right to manage and operate the business, or finances.
Can the union have a manager removed if associates think that manager is unfair?
No. Only MedStar Health has the authority to decide who its managers will be. It is important and expected that MedStar Health leaders display fairness at all times. If you feel a manager is being unfair, please contact Human Resources.
Can the union “fix” anything or “force” MedStar Health to do anything?
Once the union is voted in, the only thing the employer is required to do is bargain in good faith. This means that management must meet with the union at reasonable times and places to talk and attempt to reach an agreement about mandatory subjects of collective bargaining. It does not mean that an employer is required to agree to any specific union demands, or that the union can force the organization to give something it doesn’t have or isn’t able to give. Most labor contracts typically include a Management Rights clause that allows the organization to retain the right to run the operations of the business.
It sounds like things can only get better for us with a labor contract—is this true?
Collective bargaining is a gamble. Because it is a give-and-take negotiations process, it’s possible things can get better, worse or stay the same. Even the NLRB’s own case law states, “Collective bargaining is potentially hazardous for employees, and as a result of such negotiations, employees might possibly wind up with less benefits after unionization than before.” (228 NLRB 440) Despite any promises the union may make, nothing is guaranteed, and nobody knows what a final contract may look like.
Will all associates participate in collective bargaining?
No. Collective bargaining is between the union and employer. Each party may have a bargaining committee. It’s possible the union’s bargaining committee would consist of a few members of the bargaining unit, and those people can push to have the union focus on their priorities, even if they don’t align with yours.
If I don’t like the contract that’s negotiated, can I opt out of it?
No, once a union has been voted in and a labor contract has been negotiated, you cannot opt out of the contract, even if you don’t like the terms, never supported the union, voted “no” in the election, or no longer want the union here.
Will having a union guarantee my job?
No. The union may negotiate certain protections in a labor contract, but guaranteed job security is not something the union can provide. The NLRA gives employers the right to discharge, transfer, or lay off an employee for genuine economic reasons or for cause, such as severe misconduct.
Dues
What are union dues?
Union dues are regular payments that unions require members (employees) to pay in exchange for representation. The amount you pay in dues is decided by the union, which also has the legal right to increase how much it charges in dues at its own discretion.
Does everyone pay dues?
If you are in a position that is part of the bargaining unit, you would be subject to dues once a contract has been ratified. You are not able to opt out of union representation, nor can you opt out of a contract.
Who determines the amount of union dues we would have to pay?
A union determines the amount it charges members and has the right to increase dues at any time. Dues amounts are not negotiated—neither MedStar Health nor associates in the bargaining unit would have a say in how much the union charges in dues.
How much would associates have to pay in dues?
While we cannot say exactly how much you would have to pay in dues, here’s how much NNU typically charges its members in dues:
- For full-time RNs, dues are 2.2x your base hourly rate, up to $117 per month (or, up to $1,404 per year)
- For part-time/per diem RNs working 12 hours or less per week, per pay period, dues are 50% of the full-time RN dues amount, which could add up to as much as $702 per year
Keep in mind, if your base rate goes up, so would the amount you owe in union dues.
If the union is elected, when would we have to start paying dues?
Typically, when a union is newly elected, members are not required to pay dues until after a collective bargaining agreement is ratified.
How are union dues paid?
Dues are deducted after taxes are taken out of your paycheck, and they are not tax deductible. And, in non-right-to-work states, the union can make dues a condition of your employment, meaning you would have to pay dues to keep your job.
The union says things will only improve. Isn’t that worth the cost of dues?
There is no way the union can guarantee that things will only improve. You may end up paying dues whether or not you like the terms negotiated in the labor contract.
