Union nurses at the University of Michigan Health System will hold votes starting Monday for a possible work stoppage to protest three unfair labor practice complaints they have filed since May against UM and the refusal of the university to negotiate nurse-to-patient ratios into their contract.

Since Jan. 20, UM registered nurses have been negotiating a contract, which expired June 30. Nearly 6,000 university-employed nursing staff are represented by the University of Michigan Professional Nurse Council, an affiliate of the Michigan Nurses Association. This bargaining relationship began in 1976 and the UMPNC is the largest bargaining unit of the MNA.

"The new administration is not bargaining in good faith," said Ben Curl, a MNA staffer working on the UM contract. "Yesterday ( at a negotiating session) they told us they refuse to bargain over staffing. For months we have been trying to establish enforceable language on patient to nurse ratios."

Curl said UM's bargaining unit has gone back on promises by David Spahlinger, M.D., president of the UM Health System, who said in July that UM would commit to keep current staffing levels. "That is not what the bargaining team is saying," he said.

In a statement, UMHS said many contract issues have been resolved with the nurses. David Spahlinger, M.D., president of UMHS, said in an email to staff that the university offered an updated package to nurses that include paid parental leave to all faculty and staff.

Spahlinger also said nurses also have been offered 3-4 percent across the board pay increases over the next 3 years; increases in shift differential, weekend and on-call pay; limits on mandatory overtime; tuition reimbursement for master level courses in BSN to DNP programs; and increased professional development funding

"Nurses are critical to the delivery of safe patient care," the UMHS statement said. "The most critically ill patients in the state come to Michigan Medicine. If any of our nurses go out on strike, their absences will put patient safety at serious risk. Strikes are illegal for public employees in the state of Michigan. If an employee goes on strike, the employee is not paid for the time out on strike."

MNA officials said nurses have not decided whether to strike or not.

"If nurses vote to authorize a work stoppage based on the unfair labor practice charges committed by the employer and the and the nurse leadership feels the need to act on that authorization, nurses will give the University enough notice to plan for patient needs – at least 10 days," the MNA said. "It is inappropriate to speculate and scaremonger before nurses have met, discussed, and voted. Nurses are voting with the understanding that a yes vote is a commitment to participate if a work stoppage is scheduled."

UMHS said the health system doesn't want to codify nurse-to-patient ratios because its ratios area already in the top 2 percent of all hospitals in the country. More nurses in relation to the number of patients have been found to improve patient care and reduce mortality rates.

"We accomplished this without any contractual requirement to do so because excellent nurse staffing supports excellent patient outcomes," UMHS statement said. "We remain committed to providing this level of staffing."

Curl said the only change in the university's proposal was the addition of the parental leave policy. He said the university's latest proposal on Sept. 5 would cut nurse retirement benefits by eliminating contributions for overtime, holidays and shift differentials, set up a two-tiered lower wage scale based on the geographic location and allow management to control selection of nurse representatives to committees that address mandatory subjects of bargaining.

The nurses three unfair labor practice complaints are UM's bargaining team refusing to negotiate safe staffing levels; certain department managers telling nurses to take off pro-union T-shirts; and unilaterally changing work schedules and increasing hours for nurse practitioners in two departments, including the cardiovascular intensive care unit, Curl said.

John Karebian, executive director of the Michigan Nurses Association, said one of the problems nurses have faced in the past two years is that UM has brought in new administrators who don't have a sense of history or respect with the nurses as have past administrations.

"After the strike in the 1980s, we developed a good labor-management working relationship," Karebian said. "It has worked relatively well. When we had issues there, we sat down with administration and worked things out."

Karebian said the working relationship has changed for the worse over the last few years.

"The idea of 'trust us' doesn't work anymore," he said. "Who serves on committees has become a bigger issue over the last contract and more important than before. Management should have a right to have their people on committees, but the union should have the right to select their own nurses, too."

Karebian said UMHS can afford to maintain retirement benefit for nurses. Last summer, Michigan Medicine, the parent organization of UMHS, earned operating income of $103 million on revenue of $4.3 billion for fiscal 2018 that ended June 30.