Providence workers are building union power

For Erika Taylor, the idea of forming a union began during a lunch break. Taylor, a respiratory therapist at Providence Hood River (Ore.) Memorial Hospital, works in a small rural facility where on nights and weekends, she may be the only respiratory therapist on duty. She questioned why she was clocking out for a 30-minute lunch when she remained available to patients during her break.

She raised the issue with management and for nearly a year and a half pushed for a solution. Eventually, the solution they decided on applied only to respiratory therapists working certain shifts.

"I didn't feel like we were making any headway," says Taylor. "Once I started talking to other departments, I realized everybody had their beef. We all love our jobs, and we all love our little hospital, and we can like work in our community but there are things that we don't love."

Taylor's experience was specific to her job and her hospital, but the frustration behind it-trying to solve workplace problems without a strong enough voice-was not. This frustration may explain why hundreds of health professionals across Providence Oregon have voted to join the Oregon Nurses Association, broadening representation beyond the nurses already represented at Providence. The new hospital bargaining units are located at Providence Portland, Providence Hood River, Providence Willamette Falls and most recently, Providence Milwaukie.

The organizing wins come as eight ONA-represented bargaining units at Providence prepare to negotiate contracts that expire at the end of 2026 and early 2027. Last year, nearly 5,000 workers from 11 Providence bargaining units went on strike for 46 days and ended up with smarter staffing for patient care, significant wage increases and unified contracts to improve solidarity.

A broad collection of professionals

The victories bring together a wide array of health professionals. The job titles in new bargaining units are varied and include chaplains, dietitians, medical lab techs, MRI techs, occupational therapists, pharmacists, physical therapists, radiation therapists, rehabilitation assistants, respiratory therapists, social workers, speech-language pathologists, surgical techs and ultrasound techs.

"Being part of a union is important so that we can navigate the rapidly changing healthcare environment," says Diana Shiroky, a speech-language pathologist at Providence Portland. "At Providence Portland we will be near wall-to-wall represented by ONA. While our job responsibilities may be different, all the bargaining units will work together with administration to make improvements to employee recruitment and retention while maintaining high patient satisfaction."

Interdependent at the bedside

As a speech-language pathologist, Shiroky specializes in swallowing disorders. Her work takes her throughout the hospital and requires her to collaborate with many members of the patient care team. She works in every unit of the hospital except the NICU.

"We work closely with most disciplines. We work with basically all of the physician subspecialties because anything that affects the heart, lungs or brain is going to affect swallowing," she says. "We obviously work with nurses very closely. We work with respiratory therapists. We work with dietitians because depending on how our patients are doing, we sometimes recommend feeding tubes. We're well-integrated. Our team is really integrated in most of the Providence system."

Patients encounter these health professionals separately, but the care they provide is interdependent. And so is their organizing. That's what makes ONA's organizing effort at Providence significant beyond the number of health professionals who have voted to join the union. At hospitals where nurses have long had collective bargaining rights, more health professionals working with them are gaining those rights.

More seats at the bargaining table

This also raises a question: What happens when more people who depend on one another to care for patients also have a seat at the bargaining table?

Not every healthcare worker has the same professional concerns. Everyone has a unique set of abilities and responsibilities when it comes to patient care. Additionally, they have different reasons for organizing. But as workers started talking across departments, they discovered how their concerns converged: staffing, recruitment and retention, continuing education, burnout, equipment, and the ability to have a say in decisions affecting their work. "We've had difficulties recruiting and retaining techs for years," says Taylor. "It has felt at times like a revolving door."

At Providence Portland, Shiroky worries about retaining highly specialized professionals. Her speech pathology department is small, and developing the expertise needed to care for some of the hospital's most complex patients takes years. Losing an experienced professional can have consequences that extend well beyond filling a position.

Continuing education and adequate equipment are part of that equation, says Shiroky. "We need well-maintained equipment. We need safe working conditions for our patients."

The professionals and technical workers at Providence also had something many workers thinking about organizing don't have: unionized nurses working beside them every day. That made it easier to see the power of collective bargaining.

Taylor looked at the nurses and saw workers with better pay, stronger safety standards, and a collective voice for raising concerns. The 2025 ONA nurses strike made the union difference even more visible.

Shiroky says workers at her hospital watched what happened during the strike and after the nurses settled their contract. For some of her colleagues who were on the fence, seeing the power of having a collective voice made a difference. Having the nurses answer questions and reassure people worried about retaliation or what unionizing would mean for their jobs also helped, says Shiroky.

"The increased union density across Providence Oregon will benefit patients and all workers," says Kaleigh Roehl, a nurse at Providence Portland. "Despite its not-for-profit classification, Providence is the embodiment of corporatized healthcare, where profits are put before patients every day. But when workers come together in solidarity, we are able to build power together and hold hospital executives accountable for the decisions they make that impact the health and safety of our community."

"If there is a strength-in-numbers concept," says Taylor, "I think that will be a real asset to our facilities."

Finding common ground

This doesn't mean that bargaining will be easy. Shiroky says workers already recognize that a contract will have to account for the particular needs of many different professions. But even with those differences, there is common ground.

"People like working at Providence," she days.

Taylor agrees. "This is not some big anti-Providence fight," she points out. Instead, workers are making the case for the tools and resources they need to do their jobs effectively and about who should have a say in determining those needs.

She believes that ONA's momentum could continue. Once workers secure their first contracts, Taylor says she wouldn't be surprised if workers at other Providence hospitals look at what their colleagues have accomplished and think about how they can achieve the same representation.

"We work for the same company, doing the same jobs," says Taylor, adding, "I think the longevity of these hospitals and the staff satisfaction within them is only going to improve."

For Shiroky, watching workers across the professions come together has already restored some of the hope lost during the difficult years since the COVID-19 pandemic. "At the heart of it," she says, "the people who are left still have the goals that we did before, which is taking care of our patients and doing our jobs well."

[Adrienne Coles]