‘We stand together’

Inside a wave of organizing in New Jersey

Inside building 14 at Bergen New Bridge Medical Center-a wing dedicated to mental health and substance use-Nathan Hultstrom spends his shifts ensuring that he and his fellow peer recovery specialists are keeping their patients safe and cared for.

At Bergen New Bridge Medical Center, peer recovery specialists joined HPAE Local 5091's non-nursing professional bargaining unit after a recognition agreement.

"When someone comes to us, especially for detox, they are saying, 'I am not safe to live my life on my own terms. Will you keep me safe from myself and from others in my life?' It's a covenant that we're making with them. It's like an agreement. We have to honor that agreement. We have to have the tools necessary to be there for them."

Honoring that agreement is easier with a voice in how the work gets done, which is why Hultstrom and his colleagues voted to join a union.

Healthcare doesn't begin or end at the hospital bedside. It can mean helping someone with addiction navigate recovery. It can mean making sure medications work safely together. And, sometimes, it can mean helping patients and families navigate the final days of life.

Across New Jersey, the health professionals doing this work are finding something else in common: They want a greater voice in the decisions that affect their jobs and their patients.

In recent months, healthcare professionals at New Jersey healthcare systems have organized with Health Professionals and Allied Employees. They include Bergen New Bridge Medical Center in Paramus; Secaucus (N.J.) University Hospital, and Samaritan Healthcare and Hospice, which has three locations in South Jersey: Mount Holly, Mount Laurel and Voorhees.

The healthcare workers' jobs are different. So are the patients who they serve and the places where they work. But their organizing offers a window into how much patient care depends on a network of health professionals whose work takes place beyond what people think of as healthcare as well as what can happen when those workers feel they don't have enough say over the conditions under which that care is provided.

Recovery depends on connection

At Bergen New Bridge Medical Center, peer recovery specialists recently join HPAE Local 5091's non-nursing professional bargaining unit after a recognition agreement, expanding a bargaining unit that already represents a wide range of professionals at the hospital.

Peer recovery specialists like Hultstrom occupy a distinctive place on the healthcare team. Their work is centered on helping people navigate recovery.

"As peers, we are the middle ground between the clinical staff and the people in recovery," says Hultstrom. "We are able to talk about our status as recovering addicts, recovering alcoholics, people of recovery, and we're able to use our lived experience to guide people, to coach them, to provide support, to provide a level of empathy that maybe other people don't have because they haven't been through the same experience."

The stakes of this work are high and rising when staffing is short. Hultstrom notes, "If no one is paying attention because there aren't enough hands on deck ... someone can find themselves in real danger," he says.

Hultstrom says it was important to have a way to address any staffing and safety concerns: "We needed to make sure those things were in place so that we could do our job safely and to keep our clients safe. That was the initial push for organizing."

Recognition means the peer recovery specialists will now negotiate over wages, hours and working conditions alongside other union professionals at New Bridge.

Hospital can't function without them

At Secaucus University Hospital, a variety of health professionals voted to join HPAE Local 5147.

At Secaucus University Hospital, the answer to who provides care is found in the variety of health professionals who recently voted to join HPAE Local 5147: social workers, pharmacists, physical therapists, dietitians and speech language pathologists. The variety illustrates just how integrated modern healthcare has become. Each worker brings something different to patient care.

Pharmacist Mikka Kowlessar knows this well. "We are the first line of protection after the doctor." If you ask doctors how many years of pharmacology they had in school, "they'll probably tell you one semester to two," she says, adding, "Doctors are very knowledgeable, and we need them 100 percent but sometimes they will order something, and it will be completely wrong. That could be the difference between treating the patient or hurting the patient. Without us dispensing the right medication or making sure people are getting the right dose, or to help them prep for the anesthesia, the hospital couldn't function."

This was the second time the professionals had tried to organize. "Initially, when we wanted to organize, it was because we felt we were underpaid and underappreciated," says Kowlessar. This time, the issues were the same, but the main focus was on job security because of the hospital's merger. "People started to get laid off, and we started to hear rumors about closures," she says, adding that an increase in insurance premiums was also a concern, especially with the cost of living going up. "We were still getting paid the same, and our insurance premiums are higher."

The Secaucus professionals had an advantage as well: Unionized co-workers, including nurses, techs and service workers, helped bolster their organizing efforts at the hospital. HPAE President Debbie White credited that solidarity. "These workers have worked at a hospital where the majority of their colleagues are members of HPAE Local 5147. They have seen the power and solidarity that belonging to a union gives workers."

In the past nine months, nearly 250 workers employed by five different organizations have organized with HPAE. "We are proud to welcome these new members as they come to understand what we have long known," says White. "Unionizing is the most effective way for workers to gain a meaningful voice in their workplace," says White.

Care at the end of life

At Samaritan Healthcare and Hospice, workers including nurses, advance practice nurses, nurse practitioners, field nurses and clinical educators as well as social workers, bereavement counselors, spiritual support counselors, and music therapists voted to join HPAE Local 5131.

The victories offer an example of how the boundaries of union representation within healthcare are expanding across care teams.

At Samaritan Healthcare and Hospice, workers, including nurses, advanced practice nurses, nurse practitioners, field nurses and clinical educators as well as social workers, bereavement counselors, spiritual support counselors and music therapists voted to join HPAE Local 5131.

Together, they provide care at a particularly vulnerable point in the lives of their patients and their families. Samaritan provides hospice, palliative and primary care at their facilities as well as care for patients in other residential facilities and in their homes. Healthcare at the end of life involves more than managing symptoms. Patients and families also need emotional, social and spiritual support. Workers say staffing and workload have left them stretched too thin to deliver on that mission.

For registered nurse Patti Sparacio, organizing offered a way to address their concerns collectively. "Management was cutting services and staffing, all the things that made us great," she says. "We just weren't happy with the care that our patients were getting. We felt like they were putting profit before the patients."

Sparacio says patients waited too long for nursing care. "We're hospice. We weren't delivering the care that we would want our parents to receive. Samaritan had an outstanding reputation in our community, and it's starting to diminish."

Now that they are part of HPAE, she wants to repair their reputation. "We're going to do everything to get us back to our original mission. We're the oldest hospice in New Jersey. When given the adequate resources and staffing, we're amazing at what we do."

Julia D'Amico, a music therapist at Samaritan, says that the health professionals who were organized had similar issues, regardless of their titles. "We didn't like the way we were being treated," she says. Management said that the facility didn't have a budget for certain programs, like the Center for Grief.

"We were expected to do all these additional things suddenly for no pay," she says, adding that the facility started using volunteers, blurring the line between what music volunteers do and what music therapists do.

Music therapy has been a recognized field since the 1950s, and music therapists work in all sorts of different facilities, from premature babies in the NICU to end-of-life care, says D'Amico. "Hospice is cool because we use music to help people process different things. Music has a lot of power in our lives, and so we use that in hospice, especially to help people who are dealing with pain or anxiety or sadness. Music can really meet people where they're at. I've found a lot of fulfillment working with my patients and helping them process and be able to speak and have some dignity and a voice.

"It took a little while to get people to not be afraid and stand with us, but it got easier the more people that were involved," says D'Amico. "The only way that we can get power and have a seat at the table is if we stand together."

[Adrienne Coles/Photos courtesy HPAE]