Indiana does not have enough nurses. Will unionization or legislation help?

IU Methodist Hospital | Courtesy of IndyTaylor/Wikipedia

Indiana University Health nurses at University and Methodist hospitals in Indianapolis are pushing to unionize. Foremost among their concerns are staffing issues, as hospitals continue to struggle to care for Hoosiers and recruit local nurses to do so.

This issue, which became exacerbated during the COVID-19 pandemic, led the nonprofit to hire 700 travel nurses in Oct. 2021 and another 600 in Jan. 2022. The proportion of nurses that are contracted travelers at the facilities is likely still relatively high, according to one IU Health employee who preferred to remain anonymous. 

Travel nurses typically work a three to six month contract with the ability to extend and continue working in a particular city.  

Courtesy of Liz Kaye/Indiana University

114 out of the 199 total job openings for nursing positions at the University and Methodist hospitals offer benefits for nurses to move to Indianapolis, providing further evidence of difficulties in recruiting local nurses. 169 students entered the most recent class of nursing students at Indiana University-Indianapolis, and hundreds more compose the most recent classes of Ivy Tech – Indianapolis, Marian University and the University of Indianapolis, but where they are going is not as clear. Although 95 percent of IU School of Nursing graduates apply for licensure in the state of Indiana, as do around 90 percent of Ivy Tech graduates, the demand around the state is much higher than the supply

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Around 40 percent of nurses at the Methodist and University hospitals have expressed interest in unionizing according to one organizer of the effort. The organizers intend to hold a vote next year, and hope to raise that number to 50-70 percent. Since travel nurses are not included in the union due to  their contracts being negotiated by their staffing agency, that number may be more difficult to reach. 


The organizers of the push for unionization have also said they are concerned about being left out of the patient-care decision-making process by hospital bureaucracies. Similar concerns were also seen in pushes for nurses to unionize in Pennsylvania, New Jersey, Wisconsin, and elsewhere across the country. These issues have also been pointed to as a factor in low nurse retention rates nationally, as more than 17 percent of nurses quit their position within a year, and 56 percent quit within five years..

Legislative actions

Rep. Cindy Ledbetter | Courtesy of Indiana House Republicans

Some Indiana legislators have taken notice of the issue. Representative Cindy Ledbetter, herself a doctor of nursing, authored House Bill 1015 this year, which would require hospitals to establish nurse staffing councils that would create a staffing plan and distribute it to all hospital employees. 

The bill might cover things like the number of patients assigned to each nurse, the number of nurses and patient care technicians on each unit and shift, among other things. Staff would then be able to file a report with the council any time their units change the plan. 

The bill also aims to prevent nurses from being subject to mandatory overtime requirements, outside of in certain cases such as when a nurse would need to finish a procedure on a patient. 

House Bill 1059, also authored by Ledbetter, would grant wider practice authority to nurse practitioners and remove some requirements that they be overseen by a physician, bringing state law closer to 27 other states which have already granted nurse practitioners full authority to practice independently. 

Only time will tell whether these bills will pass out of the legislature, or whether efforts to unionize at IU Health hospitals will succeed..

Click here for further updates about House Bill 1015, and here for updates about House Bill 1059.

(Featured image courtesy of IndyTaylor/Wikipedia)

Jacob Stewart is a senior majoring in neuroscience at IUPUI and the editor-in-chief of The Collegiate Commons.

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