Advanced Practice Providers Push to Unionize in Oregon

It’s not just physicians who are moving to unionize: More than 600 advanced practice providers (APPs) at the Oregon Health & Science University Hospital (OHSU) system have announced their intent to join a union.

Members of the group include nurse practitioners (NPs), certified nurse midwives, and physician assistants (PAs), according to the Oregon Nurses Association (ONA), which already represents more than 3,000 registered nurses in the OHSU system.

The APPs serve as faculty, in addition to caring for patients in areas like family practice, cardiology, and oncology; they work in locations across the state.

Ultimately, the group is seeking “a compensation system that reflects the complexity and diversity of their positions, the agency to discuss productivity goals and expectations with management, recognition for their roles in improving patient care and access to care, and the time and financial support to pursue educational and faculty advancement opportunities,” ONA stated.

“For many of our patients, we’re where their care starts and ends,” Heather Reed, NP, who practices in family medicine, told MedPage Today.

Reed said she and her colleagues have concerns that the health system is more focused on profits than it is on providers and patients. Provider turnover is another issue, she said.

LaDonna Robey, NP, who practices in outpatient oncology, expressed similar concerns, and noted that she and her colleagues have shouldered additional responsibility as APPs, but without proper communication and compensation.

Robey told MedPage Today that “our top priority is retention because, without retention, patient care is compromised.”

Both Reed and Robey said they have already heard from other healthcare professionals — at OHSU and beyond — who have expressed interested in their efforts. There’s been a resurgence in unionization efforts by physicians and other healthcare workers in the U.S., and many of those involved have noted they became motivated and encouraged by watching each other.

Because the APPs at OHSU are public employees, union recognition could happen voluntarily if OHSU agrees to it, or through a card check (union authorization cards) handled by the state’s Employment Relations Board, ONA noted.

In an statement provided to MedPage Today via email, the health system said: “OHSU recognizes and respects our employees’ right to unionize, and this extends to our advanced practice providers. These clinicians are essential to our success, and we highly value their contributions to the patient care team. OHSU has had a long and productive relationship with organized labor, and remains committed to supporting all of our advanced practice providers as they provide Oregonians with quality, compassionate care.”

Overall, ONA represents more than 17,000 nurses and other healthcare workers throughout the state.

In October 2023, ONA-represented nurses at OHSU voted to approve a new contract. The nurses “secured significant wage increases, guaranteed minimum staffing standards, improved workplace safety protections, the right to bargain the impacts of a merger with Legacy Health system, and full retro pay,” ONA stated.