ROCHESTER – Cheryl Tran wasn’t even supposed to be at work the day union members picketed outside of St. Marys Hospital.

A facilities worker at Mayo Clinic for more than 40 years, Tran had the week off but showed up to picket on May 28 as hospital support staffers negotiate their latest contract with Mayo.

“It’s time we get some fair wages, staffing, break times,” Tran said. “It’s been a struggle.”

Mayo Clinic is one of the world’s top hospitals, but hundreds of Rochester workers say the medical system isn’t treating its workers like they’re world-class.

About 1,600 unionized clinical technicians, personal care attendants, janitors and others are seeking at least $20-per-hour wages, in line with other hospitals around Minnesota. Rochester nurses are looking into unionizing, which would create a union with more than 6,500 members in Minnesota’s third-largest city.

Meanwhile, thousands more workers are set to come to Rochester as Mayo builds its $5 billion expansion downtown.

“[Mayo officials] treat our physicians like royalty,” said Tiffany Lawler of the Med City Nursing Alliance, a group of nurses spearheading the unionization effort in Rochester. “I wish they could treat their nursing staff as well.”

In a statement, Mayo said its leaders are continuing to address some staffing areas, but are proud of the medical system’s recruitment and retention record, which includes hiring more than 750 nurses last year.

“Nothing is more important to us than ensuring we provide the best possible care for our patients, supported by a workplace that remains a destination for top talent,” said Mayo spokeswoman Andrea Kalmanovitz.

Mayo, like other hospitals, was hit hard during COVID by mounting medical workforce shortages as staff burned out or retired. A 2022 report from the Minnesota Department of Employment and Economic Development found more than 45,000 job vacancies in the medical field alone.

But there are early signs the shortages are turning around. The Minnesota Hospital Association’s most recent annual jobs report found hospitals around the state added more than 1,100 new employees than staff who left in 2022 — the first overall net worker gain since before the pandemic.

‘They were venting, they were crying’

The staffing rebound can’t come soon enough for Mayo workers, who say the medical system doesn’t have enough workers to maintain patient care standards.

Karrie Ellingson, a personal care attendant and a member of the SEIU bargaining team at St. Marys, said her department needs 28 attendants to serve about 150 patients on average each day.

“We consistently have been working 30 percent short every day, not including PCAs who may call in ill,” she said.

Ashley Rohwer, a certified surgical technologist at Mayo for almost two decades, said in her department at St. Marys, union and nonunion workers put in a combined average of 30 hours of overtime each day.

“Most employees if they’re [scheduled] at an eight-hour shift on a regular basis, most of them are working 12-hour shifts,” she said.

Lawler started to look into unionizing after Mayo Clinic threatened to move its multibillion-dollar expansion plans out of Minnesota during the Minnesota Legislature’s 2023 session.

A Mayo lobbyist emailed Gov. Tim Walz and warned that the project could have been in jeopardy if he signed state legislation regulating hospital nurse staffing and penalizing hospitals with excessive cost growth. The legislation would have required hospitals to set up committees — with nurses making up 35% of the membership — to set staffing levels and reduce nurses’ workloads.

Mayo officials told workers the bills would have hurt operations, but Lawler said she thought they would have helped nurses have more input and protections.

“Our Legislature let us down just as much as the hospital,” she said.

A focus group on practice changes at Mayo gave Lawler a stark look at other nursing units inside St. Marys. As a labor and delivery nurse, Lawler said she saw few organizational issues — staffing wasn’t an issue and mandatory overtime only happened three or four times a year.

That wasn’t the case in other departments. The focus group of about 15 nurses revealed ongoing stress from staff shortages, an increase in events where patients become more ill or died, and a surplus of overtime across the board.

“They were venting, they were crying, they were saying how broken they were, how they were leaving the profession,” Lawler said. “The staffing situations they were in, the moral distress for not being able to care for patients they way they want in order to feel like they’re doing their job as a caregiver, their needs were not being met.”

Mayo officials have in the past defended the Rochester hospital’s medical record, emphasizing its reputation as a prominent health care center. A recent state report on preventable errors in hospitals across Minnesota showed Mayo Clinic’s number of errors decreased in the last 12-month period surveyed ending in October — 53 events in the most recent report compared to 63 events from October 2021 to October 2022.

What the future holds

In April, Mayo officials said in a letter to nurses that a union could lead to limited work flexibility and cause more workforce issues. Sherry Wolf, Mayo’s chief nursing officer, said at the time the hospital system prefers to have a direct relationship with staff.

“Working together directly helps our teams excel when caring for patients, improving processes or solving problems,” Wolf said. “Each staff member plays a role in that meaningful work. In the union environment, many important decisions will be subject to negotiation. Union engagement does not guarantee a specific result.”

The Med City Nursing Alliance hosted a silent march last month to honor nurses. The group plans to collect more information this summer about organizing a union and potentially hold a vote this fall.

Lawler said Rochester Mayo Clinic nurses will likely form their own union instead of going through the Minnesota Nurses Association, in part due to the number of nurses at Mayo.

SEIU workers have been in bargaining for a new contract since February. Among their goals: wage increases, floating holidays for non-Christian or Jewish staff and more designated break times.

Mayo has most recently proposed a 3.5% wage increase in the first year of the new contract, with another 1.5% in 2025 and 2.25% in 2026. That could mean slight wage increases of less than a dollar for some workers, according to Hallie Wallace, SEIU’s lead negotiator.

A bargaining meeting Thursday broke down as union officials and Mayo leadership couldn’t find common ground on wage proposals, or even on how long the union’s next contract should be. SEIU wants a two-year contract to renegotiate wages sooner, while Mayo reportedly won’t budge on a three-year deal.

SEIU members will vote next week on whether to enter arbitration.

Mayo officials in a statement said they’re committed to reaching “a mutually beneficial agreement.”

“We have reached tentative agreement on several topics, and we will continue to negotiate in good faith. We hope SEIU does the same, and we have historically been able to resolve our negotiations amicably,” officials said.

Union workers recently voted to abandon their arbitration agreement in favor of the right to strike during the next round of negotiations two to three years from now. The agreement has been in place between Mayo and SEIU since the 1970s.

Wallace said that’s due in part to worker frustrations around bargaining this time around.

“It will give us an immense amount of pressure in our next round of negotiations in a way that we’ve never had,” Wallace said. “I think even our members just saying the word strike … terrifies them.”