You ask, we answer!
May 2, 2025
How does MFSMC recognize and reward nurses who assume preceptor and charge nurse roles?
At MFSMC, we value and recognize the knowledge and leadership our tenured nurses provide. In recognition of this expertise, we offer an additional $3 per hour to preceptor and charge nurses with all shifts scheduled in this role. We deeply appreciate our nurses’ commitment to our patients and believe they deserve to be rewarded for their knowledge, leadership, and dedication.
What is hospital leadership doing to ensure adequate staffing resources and support for nurses?
Our leadership team is committed to ensuring nurses have the resources and support needed to provide exceptional patient care. Recent actions include:
- A dedicated cost center and budget for our stroke response unit, reducing the need to pull nurses from other units. This nationally recognized unit has streamlined resources, providing expert care and staffing stability.
- Expanding the internal float pool to nearly 200 nurses, focused on weekends and hard-to-fill shifts.
- Introducing a regional float pool and enhancing PRN support to further strengthen staffing flexibility.
- Increasing nursing staff, surgical instruments, durable medical equipment, and clinical technology.
- Growing our LPN workforce and strengthening academic partnerships to improve recruitment and training pipelines.
These efforts have led to a drop in our nurse vacancy rate from 40% to 4% and an 86% improvement in retention over the past three years.
I’ve heard that other hospitals in the D.C., Maryland, and Virginia (DMV) area voted to unionize but have been waiting for a long time to reach a contract. Is this true?
Yes, we have heard that, too. In healthcare, securing a first-time contract typically takes an average of 528 days*. This can often lead to employees becoming frustrated and possibly experiencing delays in processing important matters.
The outcome and timing of the collective bargaining process cannot be predicted or guaranteed. You can end up with less, more, or the same. And there is no way to know how long or complicated the negotiations will be.
*Analysis by Robert Combs at Bloomberg Law
April 25, 2025
Would joining a union automatically give my voice more power?
Not necessarily. In fact, it could likely do the opposite. When someone joins a union, the bargaining unit is represented collectively, which could potentially dilute individual voices. When someone joins a union, they forfeit their right to directly represent themselves for matters related to work, pay, benefits, and terms and conditions of employment. The union contract would address the collective needs of the bargaining unit as a whole, rather than individual concerns or preferences. A contract may restrict things that matter most to nurses.
I haven’t seen any organizers or heard much about a union. Why are we talking about unionization?
Unionization is such an important topic that when we hear that organizers are starting to talk with a few nurses, it is our responsibility to provide facts about what unionization means. We’re proud of our collaborative culture and believe the best way to foster teamwork and inspire growth is by continuing to work together, side-by-side as one team. We care about our nurses and deeply value open, honest communication. That’s why we are committed to ensuring you have support and resources when it comes to major decisions that could affect you and your family.
I’ve heard that if a union is voted in here and I do not pay union dues, the union could terminate me. Is that true?
It is legal and common for a labor contract in Maryland to feature language that requires all unionized employees to pay dues or agency fees as a condition of employment. In that case, if a covered employee refuses to do so, the union would notify the employer to discharge the employee.
April 18, 2025
I’ve heard the union says it could make MedStar Franklin Square hire more staff. Is that true?
No. Unions talk a lot about staffing, but they have no ability to set staffing, hire nurses or assign other caregivers to help. Without question, MedStar Franklin Square supports safe staffing and values the voice of our nurses—your voice— in ensuring quality patient care. At the end of the day, though, the responsibility for ensuring safe staffing across our hospital is the sole responsibility of the Hospital. The Joint Commission and Maryland law require this.
Those of us on the units and working with patients must maintain the discretion to deploy our nurses where and when they are most needed. We are proud that our nurses have a voice in this process through regular staffing huddles and governance councils. We always do better together.
Significantly, although the union often says it can cause hospitals to hire more nurses, this is simply not true at MWHC, where the union has represented nurses for more than a decade. In fact, in the collective bargaining agreement that governs unionized nurses at MWHC, the contract reserves the right to determine staffing solely to management. The union can ask MWHC to consider bargaining about staffing, but management has no legal obligation to do so.
The numbers support that this model is successful. At Franklin Square, our vacancy rate continues to decline—to 3.9% in March. With our stabilized workforce and increased permanent hiring, we have fewer than 15 in-house agency nurses.
Staffing challenges in healthcare are not new, and not exclusive to us at Franklin Square. But what does set us apart is the culture we create that attracts, supports and retains skilled and compassionate nurses who care deeply about our patients. Read more.
I’m hearing some people do not want a union. Why is this?
Everyone should feel welcome to express their own opinion and experiences – for or against a union. We can all learn from different points of view. Sometimes, people who thought a union was a good idea have gained experiences that have changed their minds. The reasons that motivate someone to consider unionization don’t always align with the realities of being in a union. That’s why you might hear from nurses who have been unionized in the past that they wouldn’t want to do it again. We encourage you to talk with friends and family to learn more about how promises that a union organizer might make don’t always come to fruition. Many of the recent concerns we’ve heard from our nurses are not topics that could be “fixed” by a union, but they can be addressed by associates working directly with our leaders. At Franklin Square, we are always on the side of our nurses, and that doesn’t change.
Is the Ask Us form on the website really anonymous?
Yes – the Ask Us form is completely anonymous. We have not included any fields for personal information on the Ask Us form. Information submitted on this form is not tracked to any individual. The contents of the form are shared with our nurse leaders to create new FAQs and other communications to ensure we are being responsive to your feedback. You may choose to include your name or department if you would like a personal follow-up.
April 11, 2025
What is the status of Maryland Senate Bill SB720, the so called “Safe Staffing Act of 2025?”
On April 8, 2025, the 2025 Maryland General Assembly chose not to ratify this bill and concluded their legislative session. The bill became commonly known as the “safe staffing” bill, but in actuality did not include any direct staffing mandate. The bill would have required us to expand the nurse-driven staffing huddles we hold to adjust and advocate for resources to include ancillary team members from Environmental Services, Facilities and Food and Nutrition. Currently, we review staffing internally four times a day with leaders and frontline charge nurses, and twice a day with our sister hospitals. Our priority is to ensure the staffing resources our nurses have established as a standard are in place, with our charge nurses free from direct patient care.
Without question, MedStar Health Franklin Square supports safe staffing and values the voice of our nurses in ensuring quality patient care. In fact, in her recent senate testimony on this topic, CNO Kim Schwenk expressed the positive influence of nurses on staffing decisions: “Nurses’ insight, without limitations of a bill or outside intervention, has been our success.”
I am not interested in having a union here. What can I do?
You have rights when it comes to union organizing, and it’s important to us that you understand those rights. We respect our associates’ rights to make free and informed decisions when it comes to unionization. If you are among the many nurses who aren’t sure a union is the best thing for MedStar Franklin Square, you are not alone.
Under the National Labor Relations Act (NLRA), you have the right to:
- Sign or not sign a union card, petition, or online form.
- Not to be bothered by union supporters while working or in patient care areas.
- Talk or not talk to a union representative if you are contacted at home.
- Tell union organizers you are not interested.
- Campaign for, or against, the union.
- Say “No.”
What programs are available to help me expand my professional growth at MedStar Franklin Square?
MedStar Health is committed to investing in our nurses’ growth by providing education, career advancement opportunities, and professional development support. For example, we have:
- Expanded Ed Assist and tuition reimbursement and have streamlined approvals and reimbursements.
- Launched the Clinical Advancement Program (CAP), study sessions, and a structured clinical ladder to support growth.
- Added research and EBP workshops, roving education, performance appraisals, and professional development goals to empower nurses in their careers.
- A robust Elective Learning Platform available online through myHR with categories such as Performance Reviews & Feedback, SPIRIT values, Effective Communication, Personal Productivity, and Professional Development which offers courses on critical thinking, goal setting, enhancing Microsoft Office skills, and Becoming a Manager.
We are concerned about workplace violence. What is MFSMC doing to address workplace safety, particularly violence by patients and visitors?
We are also very concerned and take this matter very seriously. The recent situations involving violence in healthcare settings is troubling to all of us, especially those on the front lines. We are prioritizing this issue through numerous new and enhanced support for our nurses. This includes the patient code of conduct, raising awareness of potential situations through security tips, sharing materials on personal and vehicle safety, and leading workplace violence prevention and de-escalation training. Importantly, we formed our Workplace Violence Prevention Committee as a direct result of nurses’ feedback, and committee members have helped identify specific actions to support nurse safety—like wanding protocols, additional panic buttons, and a list of barred individuals with a history of workplace violence.
Why did our CNO and hospital President make that Truth Pledge?
We are in a time where it’s hard to know who to believe on any given topic. When we heard that union organizers were starting to talk with our nurse associates, it became critical that we be not only leaders who support your professional growth and the stability of our hospital, but leaders who you can trust to be transparent and honest. President Levine and I take this very seriously. The relationships we have between our leaders and our associates is personally fulfilling and professionally rewarding—and we don’t want anything to come between that. That’s why we wanted to make a visible pledge to our nurses that we are committed to providing you with factual information about your work here and about unionization. We are neither pro-union nor anti-union; we are decidedly on the side of our nurses.
FAQs
Unions 101
What is a union?
A union is an organization that represents employees, serving as a single voice on behalf of a group of employees, and negotiating key aspects of employment for the members it represents, such as pay, benefits, and other terms and conditions of work. However, union representation is not free. Unions are also a business, and like all businesses, require revenue to maintain operations. Unions rely on members (employees) as a primary source of revenue, which is collected in the form of union dues and fees.
Does having a union guarantee better pay and benefits, and other improvements?
Union organizers and supporters might say a lot of things to get your support, but the union is not legally required to deliver on any of the changes it’s promising. Any changes to your pay, benefits, or working conditions would have to be negotiated between the union and MedStar Health. While either side can propose changes, there’s no requirement for the other side to agree to those changes, and neither party can simply demand things during collective bargaining.
Will I get in trouble for talking to union organizers, talking about the union, signing a card or voting for the union?
Absolutely not. Associates are free to talk about the union and take whatever action they want with regard to the union. Please just keep in mind that union discussion and organization should not happen in patient care areas, or while you are supposed to be working.
Am I required to speak with an NNU organizer, either at home or at work?
No. You are not required to speak with union organizers or supporters. If you are not interested in engaging, you have the right to ask them to leave you alone. They are not allowed to speak with you in patient care areas or while you are working. If organizers visit your home, you may treat them like any other salesperson or trespasser and ask them to leave.
Do union organizers get paid?
Yes. Consider union organizers as the union’s sales team, whose job it is to generate new business. Once the union is voted in, union organizers typically hand things off to a representative to negotiate the contract. That person may or may not be aware of what promises were made during the campaign, but either way, they are under no obligation to deliver on any of them.
How do I know whether or not to support the union?
Deciding whether or not you want to be represented by the union is a personal choice. We encourage everyone to do their own research, talk with each other, and ask questions, so you feel confident that you have all the information you need decide what’s best for you.
If the union doesn’t work out for us, can we just get rid of it?
No, you can’t “try out” a union. Once the union is voted in, if you decide you’re not happy with the representation you’re getting, you can’t just get rid of it—you would have to go through the decertification process to remove it.
Decertification is a lengthy and complex process, and one that MedStar Health is not legally allowed to help with. Like the initial organizing effort, you would need signatures from 30% of represented employees in order to file a decertification petition.
Additionally, decertification can only happen at certain times. Employees have to wait one year from the date the election results are certified by the NLRB before they can legally file a petition to try and remove the union. And if a labor contract is reached, you would have to wait an additional three years before attempting to remove the union.
Would having a union affect MedStar Health’s Magnet Status?
When we work collaboratively to achieve Magnet Status, it’s something everyone at MedStar Health is proud of. It’s a reflection of who we are as an organization and a team of caregivers, and demonstrates our team’s commitment to safe, quality patient care and to fostering a collaborative, professional work environment that strives for clinical excellence at all times.
NNU does not support Magnet Status or our shared governance model. Instead, the union believes that models of care promoted by Magnet Status “negatively impact the registered nurse’s ability to exercise independent professional judgement and advocate in the exclusive interest of the patient.”
We don’t agree with that—in fact, we’ve experienced the opposite across our system. From their position, it’s clear that NNU does not share MedStar Health’s priorities, values, and mission, and we do not want a third party undoing what we’ve worked so hard to achieve.
Union Authorization Cards
What is a union authorization card?
A union authorization card or petition is a legal document. By signing, you are potentially giving the union the sole and exclusive right to speak and act on your behalf when it comes to matters regarding wages, benefits, working conditions and other terms of employment. If the union gets signatures from at least 30% of the employees it’s seeking to represent, it can file a petition with the NLRB for a secret ballot election. And, with enough signatures (more than 50%), the union may be able to become your exclusive representative without an election.
What does a union authorization card look like?
A union authorization card can take many forms. It may be just as its name suggests—a paper card. However, it can also look like a petition, sign-in sheet, or a digital form. In fact, “signing” a card can be as easy as clicking a button. The flyers shared by union organizers around MedStar recently are promoting use of an online form, which looks like a simple interest form—it is actually an authorization form.
I was told that I have to submit an online form in order to get more information. Is that true?
No. You do not have to sign anything in order to get more information from the union. Union organizers may tell you that you’re just filling out a quick submission form in order to receive information and updates, but in reality, you may be unknowingly signing an authorization card.
Do I have to sign a union authorization card?
No, you do not have to sign an authorization card. The decision to sign something is completely up to you. You do not have to sign anything in order to ask questions, attend a meeting, or vote in an election, if there is one. And signing an authorization card does not mean you’re obligated to support the union, or vote in favor of the union if there is an election.
I signed a union authorization card, but I changed my mind. Can I get it back?
If you sign a card, or submit the online form, and then later change your mind, you have every right to ask for the card back and to tell the union you are taking back your authorization of union representation. You can do this by sending a letter via certified mail to the union’s local office. It is also a good idea to send a copy to the National Labor Relations Board regional office as well, so that they know that you have rescinded the authorization and requested that the card be revoked. Keep a copy for yourself, as well, as NNU may not acknowledge receipt.
NNU Local Office:
8455 Colesville Rd, Suite 1100
Silver Spring, MD 20910
(240) 235-2000
NLRB Regional Office:
Edward A. Garmatz U.S. Courthouse
101 W. Lombard Street, Suite 700
Baltimore, MD 21201
United States
(410) 962-2822
Collective Bargaining
What is collective bargaining?
Collective bargaining is the back-and-forth negotiation process between a union and employer to try and reach an agreement on a labor contract, also known as a collective bargaining agreement.
How long does collective bargaining take?
It takes an average of 528 days to reach a first-time labor contract in healthcare, according to a Bloomberg Law analysis. During this period, employers are required to maintain the status quo, meaning they cannot make unilateral changes to pay, benefits, or other terms and conditions of your employment.
What topics are negotiated during collective bargaining?
The only topics that must be bargained (referred to as mandatory subjects of bargaining) are pay, benefits and terms and conditions of employment, which are things like working hours, seniority, scheduling practices, promotions, transfers and grievances.
Things that are not mandatory subjects of bargaining include safety protocols, patient care procedures, equipment and supplies, number of employees hired, promoted or discharged, the right to manage and operate the business, or finances.
Can the union have a manager removed if associates think that manager is unfair?
No. Only MedStar Health has the authority to decide who its managers will be. It is important and expected that MedStar Health leaders display fairness at all times. If you feel a manager is being unfair, please contact Human Resources.
Can the union “fix” anything or “force” MedStar Health to do anything?
Once the union is voted in, the only thing the employer is required to do is bargain in good faith. This means that management must meet with the union at reasonable times and places to talk and attempt to reach an agreement about mandatory subjects of collective bargaining. It does not mean that an employer is required to agree to any specific union demands, or that the union can force the organization to give something it doesn’t have or isn’t able to give. Most labor contracts typically include a Management Rights clause that allows the organization to retain the right to run the operations of the business.
It sounds like things can only get better for us with a labor contract—is this true?
Collective bargaining is a gamble. Because it is a give-and-take negotiations process, it’s possible things can get better, worse or stay the same. Even the NLRB’s own case law states, “Collective bargaining is potentially hazardous for employees, and as a result of such negotiations, employees might possibly wind up with less benefits after unionization than before.” (228 NLRB 440) Despite any promises the union may make, nothing is guaranteed, and nobody knows what a final contract may look like.
Will all associates participate in collective bargaining?
No. Collective bargaining is between the union and employer. Each party may have a bargaining committee. It’s possible the union’s bargaining committee would consist of a few members of the bargaining unit, and those people can push to have the union focus on their priorities, even if they don’t align with yours.
If I don’t like the contract that’s negotiated, can I opt out of it?
No, once a union has been voted in and a labor contract has been negotiated, you cannot opt out of the contract, even if you don’t like the terms, never supported the union, voted “no” in the election, or no longer want the union here.
Will having a union guarantee my job?
No. The union may negotiate certain protections in a labor contract, but guaranteed job security is not something the union can provide. The NLRA gives employers the right to discharge, transfer, or lay off an employee for genuine economic reasons or for cause, such as severe misconduct.
Dues
What are union dues?
Union dues are regular payments that unions require members (employees) to pay in exchange for representation. The amount you pay in dues is decided by the union, which also has the legal right to increase how much it charges in dues at its own discretion.
Does everyone pay dues?
If you are in a position that is part of the bargaining unit, you would be subject to dues once a contract has been ratified. You are not able to opt out of union representation, nor can you opt out of a contract.
Who determines the amount of union dues we would have to pay?
A union determines the amount it charges members and has the right to increase dues at any time. Dues amounts are not negotiated—neither MedStar Health nor associates in the bargaining unit would have a say in how much the union charges in dues.
How much would associates have to pay in dues?
While we cannot say exactly how much you would have to pay in dues, here’s how much NNU typically charges its members in dues:
- For full-time RNs, dues are 2.2x your base hourly rate, up to $117 per month (or, up to $1,404 per year)
- For part-time/per diem RNs working 12 hours or less per week, per pay period, dues are 50% of the full-time RN dues amount, which could add up to as much as $702 per year
Keep in mind, if your base rate goes up, so would the amount you owe in union dues.
If the union is elected, when would we have to start paying dues?
Typically, when a union is newly elected, members are not required to pay dues until after a collective bargaining agreement is ratified.
How are union dues paid?
Dues are deducted after taxes are taken out of your paycheck, and they are not tax deductible. And, in non-right-to-work states, the union can make dues a condition of your employment, meaning you would have to pay dues to keep your job.
The union says things will only improve. Isn’t that worth the cost of dues?
There is no way the union can guarantee that things will only improve. You may end up paying dues whether or not you like the terms negotiated in the labor contract.