For the first time in nearly two decades, the union representing some 470 registered nurses at Cleveland Clinic Indian River Hospital is facing a challenge that could result in its ouster.

The election, expected to be held in a matter of weeks if approved by the National Labor Relations Board, comes after a petition calling for the decertification vote was signed by more than 30 percent of the nursing staff – the required minimum to force an election.

The call for an election comes just as negotiations are getting underway on a new two-year contract, with the existing union agreement, signed by hospital president Greg Rosencrance in 2019, slated to expire Sept. 30.

In a conference room in the hospital’s executive wing, the two sides were meeting for the second time this week to hammer out terms in a new agreement, even as the move to oust the union is underway.

The petition was filed by a Cleveland Clinic nurse, Chontal Hashemzadeh. According to the union, Hashemzadeh works on a per diem basis, meaning she is not part of the full-time staff and may work at other hospitals. She could not be reached for comment.

By NLRB regulations, it was left to Rosencrance to announce to hospital nurses on July 9 that the petition had met the NLRB threshold for an election; he did so via an internal email.

A week later, Teamsters Local 769 filed an unfair labor practice charge with the NLRB alleging Indian River Hospital management urged employees to persuade their coworkers to vote against the union.

The charge was filed last Friday. By press time Monday, the hospital had not been notified of the charge, a spokesman said.

“The hospital has violated the National Labor Relations Act by unlawfully engaging in conduct which undermines the union by encouraging the nurses to get rid of the union in exchange for better wages,” said the local’s business agent, Steve Myers.

The charge describes what Myers called a “whisper campaign” of department managers telling staff nurses they would be better off without the union; that the union was keeping them from getting higher wages and benefits; and that working conditions would improve “if they got rid of the union.”

The move affects only RNs working in the hospital itself and its inpatient behavioral health center across the street. It does not include nurses in hospital-owned physicians’ practices and clinics, where last fall’s implementation of new health records software has caused ongoing stress for staff.

The inpatient side of Cleveland Clinic Indian River has not yet implemented the change in software. But both inpatient and outpatient sides have experienced rising patient volumes and staffing shortages, to say nothing of the stress of COVID-19.

The pandemic was a factor in some nurses leaving their jobs due to fear of exposure, both for themselves and their families. During surges, nurses who stayed on were stretched thin due to illness or required isolation.

“Staffing levels are one of our top priorities,” said Myers, who said the union closely monitors nurse-to-patient ratios. “It doesn’t put money in nurses’ pockets, but it keeps nurses safe. It protects the patients also.”

Indian River Hospital has said it is actively recruiting nurses after what the union’s numbers show was a nearly 26 percent turnover rate among RNs last year. The hospital recently raised its minimum wage to $15 an hour, possibly in an effort to aid in recruitment. But that hike would not affect RNs, whose hourly base pay ranges from $25 to $39, according to the union.

That high turnover rate – 120 nurses out of the total of 463 were hired in 2020 – may prove key to whether the union stays or goes.

Both Rosencrance and Myers pointed to those recent hires as being unfamiliar with either entity. Myers thought that group may have been a significant source of signees to the petition, some of whom told him “they didn’t know what they were signing,” he claimed.

Rosencrance pointed out in his letter that “the original decision to select representation was made before many of you started working here.

“I believe a lot has changed over the years,” Rosencrance added. “However, should an election be held, we wholeheartedly support our nurses’ right to choose whether or not continued union representation is best for them.”

Unionized nurses are not common in Florida, nor are they common in Cleveland Clinic systemwide.

Indian River is the only hospital in the Cleveland Clinic Florida region with unionized nurses, though there are at least two community hospitals with union nurses in Cleveland Clinic’s Ohio region, including Akron General.

The heavily unionized Akron General merged with Cleveland Clinic in 2015. Since then, unions have held on; 800 nurses ratified a new three-year agreement in January with the Ohio Nurses Association.

Sometimes, union negotiations have a ripple effect. Among the benefits the Ohio union claims it gained for the nurses was a higher differential for night shift work – from $2 an hour extra to $5.

The hospital decided on its own to extend that benefit to nonunion workers as well. Close to 1,000 other workers at Akron General are members of the United Steelworkers Union. Their three-year contract was renewed in 2019.

Indian River’s RNs are the only nurses represented by the Teamsters Local 769, which has more than 12,000 members from Orlando to Key West.

The Vero nurses were first organized in 1998. Four years later, in 2002, there was an effort to decertify the union, but that effort failed. That same year, the Teamsters promoted lifelong Vero resident Steve Myers to business agent; he had served as shop steward at Vero’s water plant and chief shop steward for the City of Vero’s bargaining unit.

Since that 2002 vote, there has been no other effort to get rid of the union until now. But negotiations on contracts, including those taking place now, have not always been smooth. In November 2019, the union ratified a new two-year contract for the first time under Cleveland Clinic’s management.

Cleveland Clinic had announced at the start of its takeover in January 2019 that it would make no major changes at the hospital for the first year of its tenure.

According to Teamsters Local 769, however, the hospital tried in negotiations to slash by half its contribution to nurses’ union-based healthcare plan. In the final agreement, Cleveland Clinic ended up paying out the same percentage as before, the union said.

“It’s never been an easy road with the hospital,” Myers said.

Along with pay and benefits issues, the union must by law negotiate a wide range of workplace issues and conditions of employment, from mandatory vaccination to education requirements; there has been a nationwide movement to require RNs to earn a bachelor’s degree, including at Indian River.

Some unions that pushed to get their workers at the top of COVID-19 vaccination lists are now having to defend workers’ rights to resist mandatory vaccination. Barring a federal or state mandate, should Cleveland Clinic join the fast-growing ranks of more than three dozen top U.S. health systems requiring employees be vaccinated, the nurses’ union at Indian River would first have to bring management to the bargaining table.

“They’re required to notify the union and we would demand to bargain those changes,” said Myers.

While a union’s bargaining power may be reassuring, it is not free. Monthly union dues are assessed by a formula: 2.5 times the nurses’ hourly wage.

For a nurse making $25 per hour, that would amount to $60.50 in monthly dues. Dues would be $97.50 for a nurse making the top pay of $39 per hour.

Rosencrance told nurses in his letter about the decertification effort that hospital management would provide “straight-forward information in a professional manner that explains our perspective on the issue.”

“A potential election will not divide us,” said Rosencrance.