In a hospital, there is always another patient waiting. As soon as one bed empties, another is filled.

At UnityPoint in Des Moines, nurses were expected to keep that system running no matter the cost to our patients, to our licenses, or to ourselves. By 2024 our hospital systems were routinely over capacity, patient wait times were astronomical, and staffing was dangerously thin. Nurses were expected to do more with less, while executives continued to reward themselves.

That pressure pushed UnityPoint nurses to do something unprecedented: organize ourselves and become Teamsters.

Hospital administrators blamed the budget, a nursing shortage, and the state of health care: anything but their own decisions. UnityPoint is a nonprofit hospital that should be reinvesting back in our community, yet executive salaries and yearly bonuses continued to increase.

In fall of 2024, UnityPoint suddenly took away a shift differential, resulting in nurses losing thousands of dollars per year. Nurses attended meetings with hospital executives who claimed they wanted to “hear” our concerns. But instead of collaborating with nurses directly to improve conditions for patients and staff, they told us to “re-evaluate” if this was a career we wanted.

The hospital administrators were doing what I call “inactive listening.” They hear our concerns, but rarely is there action or meaningful change that follows. It was demoralizing to see hospital executives take advantage of our compassion while their cost-cutting deepened patient suffering.

Nurses knew that if we didn’t make serious changes to our workplace, patients and staff were going to continue to suffer the consequences. LOOKING FOR UNION HELP

Over the years some of our co-workers had sent out requests for organizing help, but most nursing unions dismissed us. There was no precedent for nurses self-organizing in Iowa and they didn’t think we were a safe bet. It wasn’t until we contacted Teamsters Local 90 that we encountered people who were enthusiastic about supporting us in making change at our hospital.

At around 1,100 members, Local 90 is on the small side for a Teamster local. But it's the epitome of the saying, “It’s not about the size of the dog in the fight, it’s about the size of the fight in the dog.”

The elected leaders—UPS rank and filers—ran against the longtime leadership of the union in 2022. From the beginning they have defied expectations, and as principal officer Alano De La Rosa says, “We bite off more than we can chew and then just keep chewing.”

UnityPoint is their largest bite ever. The hospital has over 2,000 potentially eligible members, many with no direct experience of unions. Still, when we told Local 90 leaders we wanted to organize, they were all in. We felt support that we’d never felt from our hospital administration.

I noticed Teamsters call each other brother or sister, and at first I thought this was strange. I quickly realized it's not just words. Teamsters brought us into their family. INSPIRING EXAMPLES

Slowly the small core of organizers brought people in one by one. We saw the success of the 10,000 nurses at Corewell Health East in Detroit who unionized with the Teamsters, and it made us believe that if they could do it, we could do it too.

We called ourselves “United Nurses of Iowa” and set out to educate our co-workers about what unions are: how people, in our case nurses, could stand together to improve conditions for all. We formed bonds with people of a variety of political backgrounds with the promise of a real voice on the job.

But as our organizing picked up, so did the repression from UnityPoint. The hospital hired a union-busting firm. They spent an estimated $6 million on negative messaging and tried to convince us the Teamsters were a bunch of dumb and vulgar truck drivers who didn’t understand health care. They tried to paint the union as a nefarious outside force when they were the ones hiring “labor consultants” to spread misinformation among staff.

We set up tables with educational flyers, Teamster swag, and snacks, and made ourselves available to answer questions from other nurses. When the hospital told us we couldn’t set up tables, we made wearable information tables that looked like we were selling concessions at a baseball game. We hosted fun events, and set up meet-and-greets to continue to connect with our co-workers. At one event an organizer dressed up as the Easter Bunny handed out candy—that is, until our bunny was forced off the premises.

A union Easter Bunny was hustled off the premises. Photo: UNI

We went into our community talking to neighbors and asking if they would put up signs in support, and found that Iowans (at churches, in coffee shops) were overwhelmingly positive.

When it became clear that we were serious about winning our union, the Teamsters sent in support from all over the country. Teamster nurses came from Michigan and California to share their knowledge with our co-workers. ELIGIBILITY GAMES

We pushed for an election that would be accessible to all nurses eligible to be part of our union. When we requested mail-in ballots, UnityPoint rejected the request, insisting on an in-person vote at the end of October. When we raised concerns about a potential government shutdown the first week of October, they dismissed them.

The government did shut down, halting all National Labor Relations Board elections, and just as UnityPoint had hoped, they had several weeks to hire new nurses and expose them to anti-union rhetoric in their orientations. Union-busters walked the hospital, pulling nurses off the floor for one-on-one discussions.

UnityPoint accused the union of causing confusion about voter eligibility, but they were the ones who provided the list of eligible voters! They encouraged people to vote knowing they were not on the list they had provided. But anyone not on the list was automatically challenged by the NLRB. It seemed their goal was to rack up challenged ballots, creating confusion and delaying our union certification.

UnityPoint also petitioned the NLRB to change the date of eligibility. The board denied that request, but UnityPoint continued to tell everyone to go vote. Then UnityPoint tried to spin the narrative that “the union” wanted to exclude nurses.

But when the votes were finally counted, we won decisively, voting union 871-666. Moving the goalposts hadn’t succeeded. Months of slander hadn’t succeeded. Nurses had come together to build something all our own, and we weren’t going to be intimidated.

It couldn’t be that simple.

A few days later our employer filed 12 legal objections, accusing everyone from the nurses to the NLRB to one of its own managers of breaking the rules. It’s a baseless legal tantrum, and its goal of stealing our victory has not been successful. Nurses are not afraid of challenges. We are used to them; we re-focus and we keep pushing forward.

Before the objection was filed we had already started preparing for the next steps: building a contract action team and a bargaining survey. We reached out to the new friends we had made in Michigan and found that they were happy to help. We had become part of a nationwide movement of worker solidarity. Their knowledge was now our knowledge; their wins were our wins.

UnityPoint has always hoped that if it could just slow us down, we would lose interest or lose hope. What management has never understood is that we’ve been a union for a long time, ever since we started fighting for each other. And our union family only continues to grow. We stand together, united and ready for whatever comes next.

Belinda Carpenter is an emergency department and critical care nurse at UnityPoint Hospitals.

Weirdly I had no issue, but hope this helps :)