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The National Nurses Organizing Committee/National Nurses United (NNOC/NNU) is targeting Rush registered nurses for union organizing and seeks to represent them in collective bargaining with Rush leadership.

Considering unionization is a personal decision, it's essential to evaluate the facts about union representation, collective bargaining, membership costs and potential risks for Rush nurses and the communities we all serve together.

The NNOC/NNU is a registered business entity of the California Nurses Association (CNA) and, as such, NNOC/NNU is governed by the CNA's bylaws and standing rules. In our market, the NNU only represents nurses at the following hospitals:

• Community First Hospital
• Cook County Hospital and Health System (nurses formerly represented by the INA)
• Jackson Park Hospital
• University of Chicago Hospitals and Clinics (nurses formerly represented by the INA)

While NNOC/NNU organizers may want you to think they have a larger presence in the Midwest market, this is not the case.

If Rush nurses elect the NNOC/NNU, collective bargaining will take place between the union and Rush leaders over wages, benefits and all other terms and conditions of employment. Here are important facts to know:

• Individual nurses cannot opt out: If nurses were to vote for union representation, the union would become the "exclusive representative" for all eligible nurses in the bargaining unit. Individual nurses would not have the right to opt out.¹
• In bargaining, the law does not require the parties to agree: Under the law, "neither party (the union nor the employer) is required to agree to a proposal or make a concession."² During bargaining, a union can propose anything, but the employer can reject or counter any proposal.
• Collective bargaining is unpredictable: In bargaining, to get something it wants – like mandatory dues from nurses – the union may trade away something you like and value, such as tuition benefits. The union could also demand provisions (i.e., strict seniority rules) that would disrupt the flexibility you now have to work with your leader and coworkers to create work schedules, and/or PTO and holiday schedules.
• A union has no power or authority to change compensation or work rules: Under the NLRA, the union can only "get" for employees what the employer agrees to offer; for any changes to terms and conditions of employment to occur, management must agree.
• Strikes can occur if bargaining breaks down: When a union makes demands that an employer is unwilling to agree to, unions can call strikes, putting patients at risk. In fact, the NNU and its affiliates call nurses out on strike more than any union representing RNs.

While Rush leaders will negotiate in good faith, unionization does not guarantee anything specific (i.e., like fixed staffing ratios) or different, and its outcomes can vary. In the end, nurses may end up with more, the same or even less favorable terms than before unionization.

During a union sales campaign, organizers frequently promise higher pay, better benefits and increased staffing to encourage you to support their efforts. However, Rush nurses need to understand that these promises are not legally binding. Union organizers often have few, if any, restrictions on what they can say, which means they may make almost any claim to persuade you to join.

Nurses represented by the NNOC/NNU would be expected to pay union dues equivalent to 2.2 times their hourly rate of pay each month, capped at $116.27 or $1,395.24. ^3.

The NNOC/NNU expects all bargaining unit members to pay dues and other fees as a condition of employment; union dues will likely be deducted from your paycheck.

Collective bargaining often means collective treatment. Through bargaining, a union and management negotiate a contract, which is often an inflexible document that requires rules to apply equally to all bargaining unit members, without exception. Under a union, our nurses could be subject to rigid terms, including restrictions that differ significantly from those we have now.

Today, we can work together to create a work experience at Rush that works for everyone. If you like the flexibility we now enjoy (i.e., scheduling, hours of work, your ability to participate in decision-making, etc.), you may find working under a collective bargaining agreement very different and less favorable.

Collective bargaining can often feel like a tug-of-war: it is time-consuming, challenging and the results can be uncertain. When collective bargaining breaks down, unions often call their members out on strike to pressure management into agreeing to their demands.

The NNOC/NNU has done this multiple times at UChicago Medicine, Cook County Hospital and Community First Medical Center. Below you can see a history of strikes led by NNU and other nurse unions (i.e., Illinois Nurses Association or INA) that have occurred recently in the Chicago market:

• 2019: University of Chicago Medical Center, NNU (Nurses)
• 2020: Amita St. Joseph Medical Center, INA (Nurses)
• 2020: University of Illinois Medical Center, INA (Nurses)
• 2021: Cook County Health System, NNU (Nurses)
• 2021: Community First Medical Center, NNU (Nurses)
• 2024: University of Illinois Medical Center, INA (Nurses)
• 2024: Amita St. Joseph Medical Center, INA (Nurses)

Healthcare strikes are disruptive and put patients and communities at risk. We strongly believe that Rush nurses and patients are better served when leaders and nurses work together to find solutions to any challenge we encounter collaboratively.

We respect your right to consider union membership; however, we believe that direct collaboration between professionals, including leaders and nurses at Rush, is essential for achieving the best outcomes for our patients and the communities we serve.

Collective bargaining can often feel like a tug-of-war: time-consuming, difficult and with an uncertain outcome. When collective bargaining breaks down, it may lead to strikes, leaving patients and families in a precarious, uncertain situation.

The organizing process begins with the union gathering signatures from at least 30% of the nurses it seeks to represent. If the union obtains sufficient signatures, it can petition the National Labor Relations Board (NLRB) for an election.

In an NLRB-secret-ballot election, only those who participate and vote have a voice in the outcome. In an NLRB election, the union would only need a simple majority of the votes cast to win, which is 50% plus one vote of all votes cast. In this case, the NNOC/NNU filed a petition for representation at the NLRB on April 8, 2026; the NRLB is currently reviewing that petition and will decide if an election should be scheduled.

It is impossible to say. However, a recent Bloomberg Law analysis found that collective bargaining for a first-time contract can take, on average, about 465 days or 15 months.

According to the CNA's bylaws and standing rules, all CNA affiliates (including NNOC/NNU) charge their members 2.2 times the member's hourly rate of pay per month, up to a cap of $116.27 per month. Here are some additional facts about NNOC/NNU dues:

• The NNOC/NNU would expect and demand that union dues payments be mandatory. Under such circumstances, nurses would have to pay union dues to work at Rush.
• Because dues are a function of a member's hourly rate of pay, including differentials, overtime, etc., the cost of dues typically increases as a member's hourly pay increases.
• Members who work 12 hours per week or less are required to pay 50% of the full dues; everyone else is expected to pay the full dues amount.
• Unions use revenue from members' dues to pay expenses such as salaries, benefits, and business expenses for union officials; the union's paid organizers; the union's office staff, including marketing, legal, and administrative support; and other union expenses, such as rent for office space and political contributions.

Rush has a large nursing workforce. If the union is successful in organizing Rush nurses, each nurse at Rush could be required to pay approximately $1,000 per year in union dues; Rush nurses collectively could lose about $ 2 million annually in dues to NNOC/NNU.

Removing a union can be extremely difficult. Nurses cannot remove a union for at least a year; if a contract is signed, they are blocked for up to three more years. To initiate removal, nurses may need to retain a lawyer and gather enough signatures for an election. But the union can oppose this process and may even discipline or fine members trying to remove the union.

You might be surprised to learn that nurses at St. Louis University Hospital (SLUH) in St. Louis, MO, are represented by the NNOC/NNU and have attempted to remove the NNOC/NNU on several occasions without success.

In addition to information shared by Rush and NNOC/NNU, nurses may visit the National Labor Relations Board (NLRB) website for neutral information about employee rights, union representation and the election process.

We believe PNS would be in jeopardy under the NNOC/NNU. The NNOC/NNU has publicly opposed Magnet and shared governance, viewing them as "marketing tools" that undermine collective bargaining efforts.

NNOC/NNU claims Magnet does not benefit nurses, stating, "Instead of being a reliable sign that a facility treats nurses well, Magnet has become a farce that co-opts nurses, gives them little input on the process, costs millions of dollars, and is primarily a marketing tool for management."⁴

Our PNS is one of the most successful shared governance models in the country; it is part of our collaborative and professional culture at Rush and is a key reason we are a six-time Magnet-certified institution.

It is impossible to say how unionization and collective bargaining could impact, and whether they might curtail or eliminate, shared governance at Rush. Today, our nurses have a voice in their practice through PNS, but under a union, many topics these committees address would now be subject to bargaining with the union.

Flexibility can be the first thing negatively impacted by unionization. Here are important things to consider about collective bargaining and flexibility:

• Scheduling and all scheduling-related issues would be subject to the collective bargaining process, and it is impossible to predict the outcome.
• Under contract rules, nurses across all departments in the organization could be restricted from working with their manager to accommodate their own personal scheduling needs.
• Such contract rules could also restrict individual nurses and managers from directly collaborating on unit issues such as holiday schedules, last-minute schedule changes and shift changes.

Collective bargaining and negotiated work rules could disrupt the kind of collaboration and flexibility we now enjoy.

Compensation at Rush is merit-based and market-driven. In addition to the annual merit process and other periodic wage adjustments, Rush regularly (at least annually) conducts comprehensive market reviews to ensure competitive pay.

Under collective bargaining, compensation and benefits are subject to negotiation, typically every three years. Unions typically prefer systems in which wage increases are provided across the board, at the same rate for all employees, without regard for individual performance.

Today, Rush can make quick decisions to react to market changes without the constraints of a collective bargaining agreement. Our approach is designed to ensure fair, competitive pay while maintaining focus on patients and a collaborative work environment.

Yes. If Rush nurses were to elect NNOC/NNU during collective bargaining, all nurses' current wages, benefits and other terms and conditions of employment, such as health insurance, school tuition, PTO and other benefits, would be subject to the give-and-take of negotiations.

Rush leaders would always negotiate in good faith. In the end, it is impossible to predict how pay and/or benefit programs might be impacted by collective bargaining or whether you would keep all the pay and benefits you have and now value.

You can check your available Rush Education Assistant Benefits Enhancement dollars in Tuition IO. Benefits are awarded annually, and managers must review and approve certification requests to ensure Enhancement Funds support relevant skill development and professional growth within employees' roles. You can review eligible expenses in the Employee Service Center – Educational Assistance Benefits (EAB).

If Rush nurses were to elect the NNOC/NNU, the full wages, benefits and other terms and conditions of employment that Rush nurses currently receive would be subject to negotiation through the collective bargaining process and, therefore, at risk of reconsideration.

NNOC/NNU does not maintain its own union-sponsored "health and welfare fund," as many unions do. Rush leaders would always negotiate in good faith. Still, it is impossible to predict how wage and benefit programs (e.g., healthcare, retirement and education benefits) might be affected by collective bargaining.

A primary factor in determining staffing at Rush is the acuity level and needs of our patients. We base staffing decisions on input from multiple sources, including our PNS staffing counsel, charge nurses, front-line nurses and nursing leaders.

Nurse staffing at Rush already exceeds that of many other hospitals. In fact, in November 2024, Rush received its ninth consecutive A grade from the Leapfrog Group, a nonprofit health care watchdog organization that grades hospitals on the quality and safety of care they provide.

No. If the union is elected, during the collective bargaining, the union would be free to ask for anything. However, Rush leaders would have the legal right to say "no" to any union proposal or demand that we felt is not right for our patients, other Rush employees and providers, or the community we serve.

Staffing at Rush is excellent, which is why Rush has consistently been named among the Top 20 on U.S. News & World Report's annual Best Hospitals Honor Roll. Rush is already among the safest and most well-staffed hospitals in the nation.

Staffing at Rush will always be based on the needs of our patients and determined with the input of our Professional Nursing Staff.

No. While NNOC/NNU emphasizes staffing in its messaging, outcomes at some NNOC/NNU-represented hospitals differ. For example, hospitals such as UChicago, Ingalls and SSM Health Saint Louis University Hospital (SSM-SLUH) have historically reported RN vacancy rates above 20%. These challenges have contributed to nurses' efforts to remove NNU as their representative.