A group of nurses at Beaumont Hospital in Royal Oak, the 1,100-bed flagship hospital of eight-hospital Beaumont Health, has launched a drive to unionize with the Michigan Nurses Association.

A statement signed by 100 of the approximately 3,000 nurses at Beaumont Royal Oak says the effort, the fourth union drive among Beaumont nurses over the past 24 years, is partly about adding jobs to increase nurse-to-patient ratios. Beaumont officials said the hospital's staffing is strong and that the group's views don't represent the majority of nurses at the hospital.

"Beaumont used to be the gold standard of health care in Michigan, but now morale is dropping ...," the union backers' statement at BeaumontNurses.Org says. "We have seen too many of our colleagues leave for other facilities that have safer staffing levels and offer better opportunities to provide quality care."

Susan Grant, R.N., Beaumont Health's executive vice president and chief nursing officer, said she has met with some of the nurses who support the union. She said the nurses talked about supporting the Michigan Nurses Association's "safe staffing" effort to increase nurse-to-patient staffing ratios.

Grant told Crain's that Beaumont respects the nurses' effort to decide whether or not they should have a union represent them.

"I don't think the concerns raised (by the 100 nurses) are represented by a majority of nurses," Grant said. "We just had a staffing survey that found 80 percent of our nurses are engaged," feel positive about working for Beaumont and want to stay.

Grant said Beaumont employs 3,000 nurses at its Royal Oak hospital.

Mary Beth Boeson, a certified nurse anesthetist with Beaumont for 24 years, said Beaumont nurses want a seat at the management table when decisions involving patient care are being made.

"We want to make Beaumont a better place to work and advocate for our patients," Boeson said.

"Being a nurse here for so long, seeing all the changes in health care, especially at Beaumont the last few years, it doesn't feel like we are putting our patients first," Boeson said. "Things have really shifted. The nursing voice has disappeared some. We know what is best for patients, and we want to have a seat at the table for patient care and staffing."

Boeson said Beaumont's nursing executives have reached out to communicate with nurses the past few months, asking what more the hospital can do.

"We have more nurses in management positions, but I am not sure how much power they have. We want to help them. We feel the collective voice of 3,000 nurses can make a difference," she said.

Boeson said floor nurses have been called from patient care duties to attend "labor relations meetings" where they are presented with information from Beaumont-hired consultants about unions.

"We have identified five different people who are having the meetings and are engaged in union busting," Boeson said. "They are using a lot of fear, saying things like if you join a union, the union will make you strike. ... There are different types of strikes: economic strikes and unfair labor practice strikes. The MNA has had two strikes in 19 years."

Grant said Beaumont has "invested in providing education for our nurses so that they receive accurate information about unionization and can make an informed decision."

In a letter to Grant from Bob Siver, a Beaumont nurse since 1994, Siver said the following about the value of being represented by the Michigan Nurses Association.

"You caution us that if Beaumont nurses were to democratically (because that's what a union represents — democracy in a workplace) select a union, the union would bargain our terms of employment (which members would then vote to accept or not)," Siver said in an email obtained by Crain's.

"I don't understand how that is necessarily a bad thing, given that currently the hospital unilaterally determines our terms of employment, giving us the choice of either accepting what's offered without negotiation or going elsewhere to work- in other words, take it or leave it," he said.

Silver said he worked at Beaumont when "in the early 2000s the Beaumont corporation colluded with several other large hospital groups to suppress nurse's wages." Beaumont paid a part of the $48 million settlement, of which $27 million went to about 20,000 nurses at eight hospital systems in Southeast Michigan.

"You might say they organized an informal union to illegally keep nurses wages lower than the market would otherwise have allowed," Siver said. "Part of the reason that collusion was successful was because of the lack of transparency with respect to wages, something that would not be possible if those terms were bargained by a union. It was only due to a multi-million dollar class action lawsuit that Beaumont (years later) was forced to restore wages lost by nurses who were employed at the time."

Asked about nurse staffing and other support cuts, Boeson said there have been more hiring freezes than actual cuts. "It is about not being able to bring new staff on board, not replacing those we have lost," she said.

Grant said Beaumont has worked to preserve nurses at the bedside to meet the needs of patients.

"We have not cut positions. Our turnover rate is well below national averages ... Some positions have been increased," said Grant. "Across the system, our No. 1 priority is to meet the needs of patients and families."

Over the past several years, Beaumont's three legacy hospitals in Royal Oak, Troy and Grosse Pointe have become certified "Magnet" nursing hospitals by the American Nurses Credentialing Center, a subsidiary of the American Nurses Association. "Our other hospitals are on the Magnet journey," she said.

The American Nurses Association is not tied to the Michigan Nursing Association and is not a union.

Only about 8 percent of the hospitals across the country have earned Magnet status, which recognizes a hospital's effort at creating a fair workplace for nurses that focuses on quality and patient safety.

Despite the Magnet status, Boeson said nurses want better nurse-to-patient staffing ratios, more support staff, adequate supplies for patients, fair wages and benefits. She said that pay raises have not kept pace with the increased health care co-pays, premiums and other changes.

Siver said he pays an extra $120 a month because his wife is offered health insurance at her job and Beaumont penalizes employees if spouses want to remain on the Beaumont policy. He said they have chosen to stay on the Beaumont policy because of the high-quality doctors and nurses in the network.

"My wife is offered insurance by her employer, which she declines because she prefers to get her health care at our world class institution, the one that helped her and I survive cancer," Siver said.

"Because of that decision, I'm penalized another $60 per pay period, on top of the increased premium I already pay," he said. "Another way of looking at it ... is the hospital doesn't pay me for three hours I work every month."

Over the next several weeks, Boeson said Beaumont nurses will hold their own educational efforts to tout the benefits of joining the union. She said it is unclear when a vote will be held.

"Today (April 29) was a really big day about coming out with letter: 100 strong," she said. "I had so many people come up to me and say, finally, this is great, the hospital really knows what we are doing. We will be talking with nurses face to face about why a union would be a great thing for Beaumont."

Beaumont Health has total net revenue of $4.7 billion and includes eight hospitals with 3,429 beds, 145 outpatient sites, nearly 5,000 physicians, 38,000 employees and 3,500 volunteers. In 2018, Beaumont Health had about 178,000 inpatient discharges, 18,000 births and 573,000 emergency visits.

Editor's Note: This story has been updated to correct Beaumont's net revenue.