The people of Iowa are often viewed as a bellwether for the United States of America, which helps explain why nurses and hospital executives and patients all around this great nation are watching with interest as Des Moines-area nurses vote on whether to unionize with the International Brotherhood of Teamsters.
An estimated 2,000 nurses employed by UnityPoint Health at Iowa Methodist Medical Center, Blank Children’s Hospital, Methodist West Hospital and Iowa Lutheran Hospital are scheduled to cast ballots Sunday, Dec. 7, through Monday, Dec. 9.
Key issues: Nurse/patient ratios, improved wages and benefits, safe working conditions and job security.
The Teamsters represent nearly 50,000 essential health care workers now, including nurses, respiratory therapists, emergency medical technicians, paramedics, CT and ultrasound technologists, emergency room technicians, blood collection specialists at American Red Cross and even doctors.
“Having rules for everybody and procedures to protect yourself is imperative in this time and age,” said Kevin Moore, a key organizer of nurses as president of Teamsters Local 299 in Detroit and the Michigan Teamsters Joint Council #43.
An estimated 9,600 nurses voted in 2024 to unionize nine Corewell Health hospitals in Southeastern Michigan. That was a huge success for nurses and the Teamsters.
“Our nurses came together because they understand the strength of unity. When this happens, hospitals have to work with nurses and not just tell them what to do. When you stand together, you win together. This is about respect on the job,” Moore told me. “A collective bargaining agreement helps you accomplish that. Voices must be heard. Hospitals are all about profitability, and people are going to fall through the cracks and die. Nurses are overworked and under-respected. We’re going to change that.”
A vote to align with the Teamsters would be a dramatic turn of events in Iowa health care and part of a national movement to organize nurses who seek a more equitable power balance. Challenges facing nurses are well documented.
UnityPoint Nurse Alex Wilken said on Monday, Dec. 1, during a Zoom interview with Julie Gammack of the Iowa Writer’s Collaborative, first excerpted by The Racontourist:
“… In the critical care unit, we take care of the sickest of the sick, right? And sometimes those patients require interventions where we need one-to-one nursing. But lately … we’ve had to do two to one, which becomes an unsafe situation for those patients … the hospital’s not hiring enough nurses … They end up feeling like they’re just triaging and that they can’t actually do what they feel like is best for the patient because there’s not enough resources, there’s not enough staff, and then they leave. So it’s not a nursing shortage problem, it’s a nursing retention problem … So it’s kind of just come to a point where we say enough is enough. The only way management’s going to do the right thing here is if we all, the workers, come together and demand as a united front, as a union. And so that’s kind of where we’re at … ”
Even the U.S. Chamber of Commerce has expressed concern about nurses leaving the workforce in record numbers, referring to the situation as “a national nursing crisis.”
Hospital executives at for-profit and non-profit health networks continue to see handsome pay packages despite industrywide staff reductions.
In Iowa, UnityPoint Health is a non-profit network that paid CEO Clay Holderman $4.6 million in annual compensation plus $350,000 in additional benefits in 2023 (for work through October), according to the organization’s IRS tax filing as Iowa Health System.
Recent data for current UnityPoint CEO Scott Kizer could not be confirmed through public documents.
Note: Iowa Health System, formed in 1993 by the merger of Iowa Methodist and Iowa Lutheran hospitals, changed its name to UnityPoint Health 12 years ago. However, tax filings as recent as 2023 may be found under Iowa Health System.
UnityPoint had $5.3 billion in total revenue in 2024, up 10% from a year earlier, according to industry news site hospitalogy.com.
A sensitive issue in Iowa is how much money UnityPoint is spending to fight the union effort, alleged to be eye-popping, according to Teamsters Local 90 in Des Moines. But seasoned labor leaders say they’ll proceed undaunted.
With healthcare affordability issues dominating headlines, labor organizers argue that enhancing the power of nurses will improve healthcare delivery.
I talked to a Corewell nurse this week who said morale among nurses spiked after their vote to affiliate with the Teamsters.
Teamsters and Corewell officials told me in recent days they’re optimistic.
“We continue to bargain in good faith and remain focused on reaching an agreement with the Teamsters. We have amazing, compassionate nurses and look forward to continuing the conversation. On average, the process to negotiate an initial union contract for health care organizations takes 1.5 to 2 years,” said Mark Geary, senior director of communications for Corewell Health.
Lead negotiator Mike Smith from the International Brotherhood of Teamsters in Washington, D.C. has worked hard to make gains on behalf of nurses in Michigan and nationally, Moore said.
“These nurses will have union representatives who are nurses,” Moore said, noting his Michigan team, led by David Hughes and Dave Trigona, is tireless. “We’ve created a nursing local, Teamsters Local 2024. We’re working on language that nurses need to protect themselves with clear-cut work rules. So many of these hospitals do not want you to have representation. We’ve got the backs of nurses.”
Corewell had $16.4 billion in total revenue in 2024, up 8.3% from a year earlier, according to industry data cited by hospitalogy.com.
Gallup polling shows nearly seven in 10 Americans support labor unions, a five-year run of support that mirrors strength not seen since the late 1950s and early 1960s. Support was strongest among workers 34 and younger at 77%, according do Gallup last year.
A headline in the Nov. 28, 2025 Building Tradesman newspaper said, “Nearly everyone, it seems, likes unions. Can labor capitalize?” The swift firing of federal workers has stoked interest in fair processes and protocol.
These days, 15% of U.S. households include someone who belongs to a labor union, which falls within the 14-21% range of the past quarter century, Gallup said in August 2025.
Current headlines have activated nurses in recent days.
While they’re required to obtain certain levels of education and be licensed, the U.S. Department of Education this year moved to exclude graduate nursing programs to a non-professional degree status that would limit school loan dollars available. The U.S. Department of Education said on its website that progressive voices have been “fear-mongering” and the Big Beautiful Bill established common-sense changes.
Sarah Johnson, a registered nurse based in Sterling Heights, Mich., has 16 years of experience and serves as a union representative for Teamsters Local 2024. While the team is busy with contract negotiations, she said in a statement to me this week, “We voted to join the Teamsters because we were ready for real change — ready to have a voice on the job and the power of solidarity on our side.”
Marick Masters, professor emeritus at the Mike Ilitch School of Business at Wayne State University in Detroit, worked closely with Mike Filler, longtime division director of the public services division that now oversees healthcare workers.
“The Teamsters, though noted for those who drive trucks, also represents about 250,000-plus people in the public sector and healthcare. They’re closely related because so much healthcare is in government. The Teamsters have a long history in these areas,” Masters said.
“They bring the resources of a very large union with staff and capability in terms of bargaining contracts. In healthcare, these are intricate contracts,” he said. “Any kind of situation that you have where management has unilateral authority, that can result in people being treated unfairly regardless of their work ethic. You lose whatever voice you have to create a more stable working condition and get people to perform at a higher level. This is about protecting workers against unfair treatment and raising the whole boat versus being at the whim of management.”
William B. Gould IV, past chairman of the National Labor Relations Board and a professor emeritus at Stanford University who began his labor law career working at Solidarity House in Detroit with legendary UAW leader Walter Reuther, has watched public opinion about organized labor ebb and flow.
“The question is whether the Teamsters can give Iowa nurses a measure of self-sufficiency and independence, improved working conditions and compensation,” Gould said.
“The principle consideration is, for a worker, what kind of ability and power and influence would they have on their own, as an individual, as opposed to operating with a group,” Gould said. “Most of us in the employment relationship have little power standing by ourselves. Most workers have to band together. That’s been the history of labor relations in our country. It’s a fact that continues today. One never knows about changing conditions … A union, in most instances, creates more certainty in that relationship.”
Phoebe Wall Howard is an award-winning reporter with a decade of experience in Des Moines and Detroit covering labor negotiations, strikes and corporate governance issues.
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