Nurses at one of Pittsburgh's largest labor and delivery centers are launching a union push this week, citing concerns about staffing and quality of patient care. SEIU Healthcare PA filed a request for a union election with the National Labor Relations Board Tuesday on behalf of nearly 1,000 registered nurses and advanced practice professionals at Magee-Womens Hospital.
"When we're regularly struggling with what we feel are inadequate staffing levels, it is difficult to care for our patients to the degree we believe they deserve," said Gianna Pomponi, who works in the adult intensive care unit at Magee. She's been a nurse for five years but volunteered at the hospital for several years prior to her nursing career.
While standards set by the Association of Women's Health, Obstetric and Neonatal Nurses recommend a ratio of one nurse for every one to two patients requiring intensive care, Pomponi said she often manages several more complex cases at a time.
"It's heartbreaking, frustrating, and exhausting to be assigned more duties than we can appropriately handle day after day," she said.
UPMC did not immediately respond to a request for comment.
Jean Stone is a staff nurse who works in the labor and delivery unit as well as the neonatal intensive care unit. For more than a decade, she said she's seen nurses go above and beyond for their patients.
"We take a lot of pride in the care that we give," Stone said. "We hustle and we're sharp for 12 and a half hours a day." But during that time, Stone said she can't count on getting a break beyond a 20-minute lunch.
"There is physical wear and tear and there's emotional wear and tear," she said, adding that requests to meet with Magee's top executives have gone unanswered.
Stone and other nurses said they're organizing to have a say in how Magee functions as well as to increase pay transparency and improve retention of experienced nurses. Stone argued all of these things factor into patient experience at the hospital.
"The most important thing is the way it affects our patients and their families and ultimately the community," Stone said.
Roughly half of all Allegheny County babies, about 10,000 per year, are born at Magee-Womens. It's also home to Pennsylvania's largest Level IV neonatal intensive care unit, which provides the highest level of care for premature and critically ill newborns. The unit treats about 1,500 critically ill babies annually.
Ashley Grieco, an 11-year neonatal intensive care unit nurse at Magee, said she is responsible for three intensive care patients at a time, which she described as an increase from the one or two it had been in years prior.
She said nurses regularly fill out internal surveys with their experiences feeling inadequately staffed, but that their stories have not led to UPMC hiring more help.
"They want to say, 'Nurses, this is your fault, and in order to make it better, time-manage better. We're not going to give you more staff, we're not going give you more [paid time-off] days so that your mental health can be better. This is something you have to figure out,'" Grieco said.
UPMC did not respond to questions about nurse vacancy rates at Magee-Womens.
Across Pennsylvania, hospital vacancy rates improved over the last two years, according to an annual survey by the Hospital and Healthsystem Association of Pennsylvania. Vacancy rates for registered nurses have declined statewide from nearly 31% in 2022 to 19% in 2024.
But the organization has stressed that current vacancy statistics don't show the whole picture. Pennsylvania's aging population is growing the need for health care professionals, which means filling current vacancies won't be enough. And Pennsylvania is projected to have the nation's biggest nurse shortage by 2026, according to a health care labor market report by Mercer, a global consulting firm.
Magee nurses said their voices aren't being heard in the boardrooms where major decisions are made.
"We are in the midst of a nursing crisis, yet decisions about patient care are being made by insurance executives with no clinical background or firsthand understanding of healthcare workers' daily responsibilities," Pomponi said.
"We need executives to invest in bedside nursing, not just the relentless drive to expand their insurance business," Stone said, referring to the growth of UPMC's health insurance arm, which expanded into five new counties this year.
Stone feels that nurses will continue to be ignored by the C-suite without the strength of a union.
"It's become crystal clear that UPMC executives will never give us a true seat at the decision-making table until we can negotiate a contract with them as a union," she said.
Magee nurses also expressed concern about what they called a retention issue at the hospital. Those with the most experience see fewer and smaller salary increases, which encourages them to look elsewhere for work and higher pay, Greico said.
"If you talk to any nurse with over 30 years of experience, they are capped," she said. "They use those words."
And that cap can vary, Stone added.
"You have no way to determine if what you're being paid is commensurate with someone with your years of experience doing the same work as you," Stone said. "It's quite literally a surprise anytime you get an adjustment or annual merit increases. You just really have nothing to base it on."
The nurses said they want to establish pay transparency with clearer expectations about salary increases.
In a statement Tuesday, SEIU Healthcare PA said the Magee-Womens unionizing effort is the largest by nurses in recent Pennsylvania history.
"Magee nurses have been working without the staff, support and resources that they need to deliver the kind of care, time and education they want to provide their patients," SEIU said. "Nurses continue to cycle through the hospital, leaving after several years due to unsustainable working conditions and a lack of the kind of benefits and investments that keep experienced nurses at the bedside."
The union's statement also took shots at what it called UPMC's "massive" executive compensation, including $30 million in recent years to former CEO Jeffrey Romoff. Tax documents show that UPMC paid Romoff $12.1 million in fiscal 2024, about $100,000 more than it paid the current CEO of UPMC, Leslie Davis. UPMC has described the payments to Romoff as deferred contractual compensation.
SEIU noted that UPMC is also second to only Kaiser as the largest provider-sponsored health insurance corporation in the United States, meaning the system provides both health services and an insurance plan. Revenue from instance claims accounted for $15.1 billion in 2024, about half of UPMC's overall revenue.
Nurses said as UPMC grows, health care staff on the frontline at hospitals like Magee are having their voices drowned out by profit goals.
"UPMC has become a huge insurance corporation, and we now have executives handing down our staffing levels, policies and working conditions," Grieco said. "People's lives are in our hands, and we must have the strongest voice in how we care for them."
Magee-Womens nurses will be joined by labor and local political leaders Thursday for a press conference at the hospital to announce their intent to unionize.
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