Some Essentia Health nurse practitioners and other advanced providers vote to unionize

More than 400 nurse practitioners, physician assistants, certified nurse midwives and clinical nurse specialists who work at a variety of clinics and hospitals in Duluth-based Essentia Health’s eastern market voted Tuesday to form a union. It is the first time so-called “advanced practice providers” have unionized at Essentia.

Organizers say it’s part of a growing trend in health care, in which more physicians and advanced level providers are unionizing. It follows a vote to form a union by hundreds of doctors, nurse practitioners and physician assistants at Allina Health last October.

“I think Allina led the way down in the Twin Cities last year,” said Ann Vreeland, a nurse practitioner at Essentia’s Northern Pines Clinic in Aurora. “And I think that you’ll find that more healthcare providers, be it MDs, DOs or advanced practice providers, are going to want more of a say about what’s going on in healthcare.”

Vreeland said about 66 percent of people who voted chose to support the union. The providers, who will be represented by the Minnesota Nurses Association, say they are seeking a stronger voice to address their concerns, including better compensation, a healthier work-life balance and patient loads.

They work at several clinics and hospitals in Essentia’s East Market, which stretches from Duluth, Hinckley, Brainerd and International Falls to Ashland and Hayward in Wisconsin.

Chris Rubesch, president of the Minnesota Nurses Association, said the providers organized for nearly a year. He said their vote to form a collective bargaining unit across different kinds of health care facilities in different cities was precedent-setting and historic.

“The work that they did to establish new legal precedent around how workers can organize a multi-facility bargaining unit is going to set the standard, for not only health care workers, but workers across the country.”

After workers voted to form the union, Essentia Health announced it plans to appeal the National Labor Relations Board decision in June to allow the advanced practice providers, or APPs, to vote in a single bargaining unit.

Essentia officials say that decision contradicts years of case law that separates hospital and clinic staff for the purposes of collective bargaining. They say the unionization of advanced providers is largely new and untested.

“We are disappointed in this outcome as we continue to believe that unionization of our professional advanced practice providers is not in the best interests of our patients or our staff,” said Tonya Loken, Essentia’s community relations director.

“A single bargaining unit that includes a wide range of settings, specialties and locations may not allow for unique approaches to caring for the different needs of patients.”

Eric Griffith, an advanced practice nurse at Essentia specializing in diabetes, said about 10 percent of advanced practice nurses nationwide are now unionized.

“We add our voices and our strength to this accelerating trend of collective bargaining amongst healthcare professionals,” Griffith said.

Essentia Health employs 15,500 people across its network, which includes 14 hospitals and 78 clinics across Minnesota, North Dakota and Wisconsin.

Correction (July 25, 2024): An earlier version of this story misstated the percent of support for the union. The story has been updated.

• Local news is in crisis. This paper has a $150 million plan
• McDonald’s is investing $100 million to bring customers back after E. coli outbreak
• South Minneapolis clinic breaks ground
• Anheuser-Busch will close Moorhead malting plant