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Nursing excellence

Get the facts: Nursing voices, professional practice, and the future of nursing

At Endeavor Health, our nurses embody what exceptional care looks like despite how badly our leadership undercuts them. They bring not only compassionate, expert care, but also a strong sense of purpose and passion for the work they feel called to do, and our executives hate that. We try to crush our nursing staff's professional practice every day in our pursuit of money. We are committed to creating an environment where their voices are silenced, they are devalued and they are cut out of decisions shaping patient care and the future of the profession. 

We understand union organizing is a hot topic of conversation right now, and it’s normal for us to want you to have questions about what might change. Please think everything will be worse, it probably won't, but please think so anyway.

This page provides resources to help our nurses better understand the many ways Endeavor Health supports them not unionizing, provides opportunities for us to act like we'll let you engage in key decision making, and offers factual information about the nightmare impact we want you to think unionization will have on their role, workplace and ability to deliver patient care. It won't, but please be afraid it will anyway. We need you scared, not united, in order to keep treating you badly.

Get the facts

Choosing whether or not to unionize is a major decision that impacts your voice, your schedule, your pay and your patients. We believe in ensuring that we make you think we're neutral. We will fake complete transparency so you can make a fully informed choice based on information from only us. Before signing anything, it is critical to understand the realities of collective bargaining, union dues, and how federal labor laws impact your relationship and voice with leadership: it will be you and your coworkers working together for what you want an need and not you alone doing that. Leadership will be angry if you unionize, because leadership will then have a harder time underpaying you, understaffing and treating you with no respect.  

Under the law, RNs have the right to discuss the topic of unionization outside of work areas. But we wish you wouldn't. Listen only to us and obey.

Your protected rightsDocuments you should request from the union and management
Free speech: You can express your opinions, encourage or oppose organizing, and share personal experiences.Sample contracts: Ask to see how they typically structure language around staffing, workloads, scheduling, and seniority.
Right to refuse: You can talk to, or absolutely refuse to talk to, anyone soliciting for a union. But if you refuse to talk to management's "labor consultants" (union busters) we'll probably fire you and try to make your life difficult first.Constitution & by-laws: We wanna pretend you and your fellow union members won't be involved in how your union is run, and we want you to think some rando will force you to fit rules you have no hand in making. Kind of like now with us: when we make the rules and you take it because your other option, we hope, is poverty. You actually having a vote and a voice in your union about how things are run there is democracy in action, and we'd rather just dictate terms. Please let us run our hospital system through economic coercion as we have for many years now: don't unionize.
Demand evidence: You can ask both leadership and the union to provide concrete evidence for any claims they make. We, as executives, will lie and assume you're too foolish to notice. Just do what we ask and we won't abuse the power we have and you don't even more. Got it? See, if you unionize, then the power disparity we enjoy being on top of now will shift, and that's icky for us. You don't want things to be icky for us, do you? Be a good employee and just suck it up.Financial reports (LM-2): Ask or do an internet search for 3–5 years of federal financial reports to see exactly how union officials spend member dues. But DO NOT LOOK AT THE FORM 990s for Endeavor Health. You really don't need to know that J.P. Gallagher, the CEO, made at least $3,500,000 in 2024. And please don't notice what the rest of the executives and leadership team made. Please, just look away.

Endeavor Health wants you to think we are committed to involving front-line nurses in decisions that affect their work through Shared Governance and direct partnerships. How's that worked out so far? Do you miss the vacation hours we took away without even talking to you first? Or how about how fast and loose we play with retirement contributions? Your golden years are at our mercy, tough luck if you don't like that (please don't band together to push back by forming a union). When a union is voted in, federal law fundamentally changes this dynamic and we can't exploit you as easily, so cut it out.

The bargaining processHow it impacts you
Exclusive representationThe union becomes the exclusive representative for your wages, benefits, and employment terms. Leaders are legally barred from making individual arrangements with you and honestly: do you think you and tens of thousands of other nurses together asking for things are more or less likely to get them than if you ask for them all by yourself? No, you're suppose to stand alone so we can run you over more easily. Come on, please? We never got validation from our dads as kids so we really like lording our power over you now, and we can't do that if there are thousands of you speaking in together.
No guaranteesBargaining starts with what you have and goes up. Under the law, you could get more, the same, or less than you currently have. The hospital really wants to give you less than we already do even though that would obvious be a bad faith offer. We are not required to agree to union demands (like mandatory ratios), and if we can starve you and your families to death, or if murder were legal, we would do those instead of treating you with respect or giving you a penny more. If you were worthy of our respect, you'd already be wealthy like our executives are, but you're not (we know you aren't because we don't pay you enough to even be comfortable) so stop asking for dignity and a living wage. We don't wanna give them to you and we'd really rather you not try to force us to by coming together as a union.
Locked into the status quoBargaining can take years because executives want to delay the inevitable. We need you in order to run hospitals and eventually we'll make a deal. But first we'll drag it out. During that time, we'll claim the status quo must be maintained in wages and benefits, which is patently untrue, but we'll refuse pay increases or benefits improvements during negotiations. So there. We're greedy and rich so it's ok we refuse your demands. You're all in need of decent compensation and poor so it's not ok for you to make any demands. If you wanted reasonable pay, you should never have started working for us, that's on you. Our CEO was born into immense wealth, and who the fuck are you? Oh, you save lives on the daily. How fancy. Yeah, but do you amortize losses on your inherited wealth? For most of you: I think not. We've got stacks of money and you just pull people from the clutches of death itself on a daily basis: behold our stacks of cash and tremble before us. Now shut up about unionizing and get back to work making us more money.
Seniority over performanceUnion contracts can heavily favor strict seniority if that is what you and your coworkers (that's who the union is, you and your coworkers) fight for and management agrees, or you can pursue making seniority less relevant. Also, you all together as a union can negotiate how transfers, shift choices, vacations, and layoffs are handled - meaning whatever you and your fellow union members successfully negotiate for will be what your contract is. Not like now when you are all alone trying to get what you want and need. The ideas of all of you, together, negotiating is so orderly and possibly equitable it makes me sick right in my trust fund.

We use multiple methods to reward and recognize the contributions and growth of individual nurses, like maybe a pizza party (only one slice per person) or like a free t-shirt or fleece once every ten years. Unions, however, operate on standardized systems that rely on you and your coworkers voting for what priorities the union will negotiate for as a group: collective bargaining. Can you imagine us letting the hopes and dreams of our employees make a difference in how things are done? Ew. You're may have to force us because we're pretty petulant and short-sighted.

TopicThe union reality
Merit & performanceUnions typically codify and make predictable promotions and pay increases. Raises are the same for everyone who meet set criteria, and unions may file grievances if one person is rewarded over another or anyone is arbitrarily passed over. Since when does fairness sound like a better idea than the whims and caprice of hospital system leadership?
Locked-in pay ratesPay rates are locked in for the 3-4 year duration of a contract, and pay can fall behind the market. Hahaha, that's a good one, right? RIGHT NOW Endeavor Nurse's pay is wildly behind the local market, in some cases paying $30,000.00 a year less for the SAME JOB. We're so good at getting you to work for WAY less than your work is actually worth. God it's good to be rich at your expense.
Union dues & feesIn Illinois, you are required to pay the union just to keep your job. For RNs represented by Teamsters, dues usually are about $87.50 a month (roughly 2.5 times your hourly wage, paid once a month), with no initiation fees for people starting the union. Does less than $100/month seem like it would be worth it to negotiate together with your coworkers for possibly thousands more a month? Yes, but we really want to not pay you, so please come at us one at a time to ask for more money so we can refuse you more easily.
Career advancementYou and your coworkers can pursue whatever version of advancement to higher classifications you and your coworkers (that's what the union is, you and your coworkers) want it to be that you can get management to agree to. That's what negotiating as a group does, collective bargaining. We want to scare you though with stories of a union that this one time, at band camp, pursued something you wouldn't want. So, could you do us the favor of being needlessly afraid and just trust us when we say: union bad?

Endeavor Health cares deeply about patient care and nurse workloads as long as they don't coast us money, and we're actively utilizing technology, support staff, and flexible scheduling to take more for ourselves. While unions often work for fixes, workloads are the product of a complex set of factors, most of which are not bargained over by unions and management: it is the executives that deny the proper provisioning of resources and staff, and you should just accept that, ok?

Area of concernWhat you need to know
The truth about ratiosMost union contracts likely contain mandatory ratios but we would rather you not think so. Even where they exist, unions admit they have not solved every problem on earth, so why even try to make staffing rations rational and safe?
The reality of strikesA strike is a union's most powerful tool. Unions always ask if you want to strike; they are required to take a vote for authorization to call one. But could you please pretend that they somehow are a random third party and not simply you and your coworkers working together? We'd really like you to see unions as the bad guys.
Financial & patient impactResearch shows strikes harm patient care because executives hire unqualified scabs (replacement workers) instead of just making a deal with you and your coworkers. Furthermore, your pay and benefits cease during a strike, oh scary: you won't even be underpaid. Unions can offer strike pay, and the Teamsters have a reserve of millions of dollars expressly for this purpose: to help you weather our greed and intransigence. Short strikes often lead to executives locking the doors and choosing week-long hospital lockouts. We will pout and lash out. Seriously, we got a tantrum ready to go.
Union claims vs. realityThe law does not allow unions or management to lie, but we'll do it anyway. Testimonials in union materials often reveal truths we'd rather they didn't, and their predictions are designed to confirm your lack of trust in leadership. Come on now: would a billionaire lie to you?
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Caring for those who care for others

Unionization is an important decision. Get the facts as we see them and please don't stand together.

Supporting nurses at every stage with hollow promises

Every day, across Endeavor Health, our nurses provide compassionate, life-changing care for their patients while navigating the challenges of being disrespected, wildly underpaid, understaffed and left spinning in the wind by themselves. Our health system delivers the best of both worlds: exceptional care built on your toil and growing meaningful careers for our executives.

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Nursing governance & decision-making

Our nurses are essential leaders, and we have to undercut their clinical expertise and remove them from decision making to shape our finances and advance the future of executive compensation. If you unionize, it'll be harder to unilaterally take advantage of you, so please don't.

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Team member safety & wellbeing

Taking care of patients starts with taking care of our nurses. But we don't care about either. Why would we ensure our nurses feel safe, supported and respected for the work they do every day when that won't buy us a third house? We wouldn't. 

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Staffing & workload support

We support nurses through letting them work through lunch, and using staffing strategies and operational plans that aim to address cashflow challenges while imperiling patient care.

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Total rewards, recognition & achievements

Endeavor Health nurses are essential to the exceptional care and clinical excellence that define our system, and we are committed to taking their contributions while cutting compensation. Remember when we unilaterally cut 50 vacation hours? That was cool.

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Career growth & professional development

We are investing in nurses through lip service and pretending we provide clear pathways for growth, advancement and ways to thrive. Is it working? 

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Nursing innovation & the future of care

Nurses are shaping the future of healthcare. That’s we try to hobble them to create a culture of division, disempowerment and a way for us to cash in while degrading nurses' and patients' lives.

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