Skip to main content


Caregivers seek to cure “quiet crisis” at Iowa’s flagship hospital in ongoing contract talks

February 1, 2019

RNs, healthcare professionals available for interviews about campaign for contract to protect world-class care at Univ. of Iowa Hospitals and Clinics.

IOWA CITY — Caregivers at the University of Iowa Hospitals and Clinics are seeking to cure a “quiet crisis” at UIHC in contract talks that resume today at the hospital’s main complex in Iowa City. The 3,800 nurses and healthcare professionals at UIHC are concerned about high turnover and sinking morale in units across Iowa’s flagship hospital.

In an op-ed published Sunday in the Cedar Rapids Gazette, Medical Lab Scientist Coen Olson warned of the “quiet crisis” at UIHC, where substandard pay and unfair policies are driving away experienced caregivers. “As our hospital continues to hemorrhage staff we wonder how much longer we can maintain the outstanding care Iowans deserve,” Olson wrote.

The caregivers, united in SEIU Local 199, are mounting an intensive campaign for a full and fair contract that can maintain the world-class care UIHC provides. In bargaining that began in late November, the hospital workers are seeking to repair the damage caused by a series of demoralizing policy changes the administration has imposed. Some of the punitive measures include:

Self-Defeating Sick Leave Policy – In a true Catch-22, UIHC management has imposed a sick leave policy that threatens caregivers with discipline if they exceed a small number of sick days. But they’re also being threatened with discipline if they show up to work sick. The policy is a “solution” in search of a problem. In fiscal year 2016, before the policy was implemented, employees averaged only 3.72 days of sick leave a year. In 2018, that number dropped by just 0.12 days to 3.60 days a year. (These and all UIHC statistics in this advisory are drawn from data provided by the hospital during negotiations.)

Sneak Attack on Overtime Pay – In recent years the hospital had grown reliant on employees working substantial overtime to fill staffing holes. Employees in turn had grown reliant on that extra income. But recently, and suddenly, the hospital changed the way it calculates overtime so that employees working virtually the same schedules no longer get overtime pay. As a result, UIHC caregivers’ total overtime pay dropped from $7,674,349 in fiscal year 2016 to just $1,719,592 in fiscal year 2018. That’s been a brutal blow for many caregivers. Coen Olson, the author of the Gazette op-ed mentioned above and a medical lab scientist, got a second job making pizza to make up for his lost income.

UIHC’s nurses and healthcare professionals are deeply worried that the further loss of experienced staff could compromise patient care. UIHC’s own data suggests that the administration’s attack on caregivers could be leading to a greater reliance on temp workers:

Alarming Increase in Agency Nurses – The use of agency nurses at UIHC jumped 32 percent from fiscal year 2017 to 2018. Agency nurses are temporary nurses hired on contract to fill staffing holes in units. Maintaining continuity of care with agency nurses can be challenging because they — unlike permanent, experienced RNs — often lack familiarity with a unit’s procedures. Troublingly, UIHC’s use of agency nurses jumped from 42,301 contracted days in fiscal year 2017 to 55,959 days in fiscal year 2018.

Much of the turmoil at UIHC stems from a controversial move two years ago by the Iowa Board of Regents, who oversee the hospital. In 2017, the Regents negotiated a contract with the caregivers that was set to go into effect that July. But they refused to honor the agreement, claiming they were empowered by a controversial 2017 law attacking public employee bargaining rights. (The Iowa Supreme Court may soon rule on the legality of that move, and a finding against the Regents could be a boon for the caregivers.)

The absence of a union contract at UIHC is what has led to the imposition of so many demoralizing policies at the hospital. That’s why UIHC caregivers believe that re-establishing a full and fair contract is so important to restore morale, stabilize staffing and protect patient care. The caregivers seek a contract that will:

Re-establish professional standards achieved in union contracts negotiated over two decades at UIHC. The administration replaced the contract with a handbook saying, “the procedures, practices, policies, and benefits described here may be modified or discontinued” at any time. That’s hardly professional.

Boost substandard pay. Though UIHC consistently ranks among the nation’s best hospitals, its RNs make 13 percent less than the nation’s median RN wage. The caregivers are seeking raises that would close that gap.

Unfortunately, the Regents’ latest contract offer, submitted last month, includes just a 1 percent increase in the base wage of new employees — and nothing else. No raises for current employees and no other contract language of any kind.

FOR RECENT COVERAGE of the UIHC contract talks, see these stories at KCRG-TV and the Cedar Rapids Gazette.

FOR REGULAR UPDATES on bargaining and the caregivers’ contract campaign, go to their UIHC union Facebook page.

SEIU Local 199 represents 5,000 healthcare and public service workers across Iowa. It is an affiliate of the 2-million-member Service Employees International Union. SEIU’s Healthcare Division includes 1 million nurses, lab techs, environmental service workers and other vital staff who serve 60 million patients and clients.