The resident doctors and nurses at George Washington University Hospital moved to unionize this month, joining residents at Children’s National, Howard University and St. Elizabeths hospitals. (Craig Hudson/for The Washington Post)
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The resident doctors and nurses at George Washington University Hospital moved to unionize this month, joining a growing number of health workers across the country seeking more influence over workplace conditions as they warn that staffing shortages and burnout compromise patient care.

The decision — at the three-year mark of the coronavirus pandemic — follows a grueling winter season that saw the flu, covid-19 and respiratory syncytial virus (RSV) combine into a crush of respiratory illnesses that doctors say further stressed front-line staff at GWU, one of several Level 1 trauma centers in D.C.

GWU workers say they were emboldened to organize by labor wins in the private sector at companies such as Amazon and Starbucks as well as their colleagues at District hospitals, including residents from Children’s National Hospital who rallied in the rain late last year, some still in white lab coats, for better working conditions.

With physician suicide risk factors amplified by the pandemic, the health-care providers say collective bargaining would give them leverage to seek higher wages, guaranteed mental health benefits outside the hospital and a limit on the number of patients they are asked to treat at a given time.

Residents, physicians-in-training employed by the George Washington University School of Medicine and Health Sciences, earlier this month petitioned the National Labor Relations Board (NLRB) to join the Committee of Interns and Residents, a branch of the Service Employees International Union representing about 25,000 residents and fellows.

With 450 to 500 residents likely eligible for collective bargaining, the GWU chapter would become the largest residency program in the District to unionize, joining residents at Children’s National, Howard University and St. Elizabeths hospitals. (The union does not have members in Maryland or Virginia, a spokeswoman said.)

“There’s only so much we can change without a seat at the bargaining table where decisions are being made about our welfare and working conditions,” said Katia DaSilva, a second-year OB/GYN resident physician at GWU.

In response to questions about the unionizing effort, a university spokeswoman shared a letter that Barbara Bass, dean of the medical school, sent Thursday to residents praising the “key role” they play on patient-care teams and expressing gratitude for their “contributions to the heath and wellness of the patients you serve.”

Bass said the university will follow NLRB processes, including a secret ballot election, and said union representation is a personal decision for each resident.

In a separate effort, the D.C. Nurses Association filed a petition on Wednesday with the NLRB to represent about 750 registered nurses at George Washington University Hospital, which is owned by Universal Health Services, one of the nation’s largest for-profit health-care companies. Neither bargaining unit has set an election date yet.

Both groups question how the medical school and GW Medical Faculty Associates, a group of outpatient doctors who also treat patients at the hospital, will find enough staff to run Cedar Hill Regional Medical Center, GW Health. The hospital under construction in Southeast Washington will serve a medically marginalized population in Ward 8 that has a 15-year life expectancy gap compared with Ward 3, according to District data.

“Staffing has become a real problem,” said Edward Smith, executive director of the D.C. Nurses Association, which represents about 2,000 nurses and licensed health-care professionals in the District. “A lot of nurses are leaving the employ and certainly nationwide nurses are leaving the profession because it has just been too hard to keep up with staffing and the demands of the profession, and that’s certainly true at George Washington Hospital.”

As front-line workers who interact the most with patients, nurses and residents have absorbed the greatest friction of structural problems afflicting hospital systems across the country that both predated the pandemic and were exacerbated by it.

Understaffing concerns drove major work stoppages, such as strikes, across the country in 2022, a year that saw health service sector workers account for the second-highest share of direct action with 36,800 employees involved, according to the U.S. Bureau of Labor Statistics. Although union membership nationally declined last year, health workers have been increasingly vocal during the pandemic about the conditions driving them from the industry.

Owen Lee-Park, a third-year emergency medicine resident at GWU, said that during surges in the coronavirus he had to cancel holiday travel to fill in for sick colleagues, a responsibility he was happy to bear but that takes a toll after three years. A benefit dedicated to combat this burden, such as a once-a-month day off, would help, said the 30-year-old from Ellicott City.

“Whether to stay at George Washington or not is something that I am questioning and contemplating deeply over the past three years of the pandemic,” he said. “The hospital’s response to nursing and [residents] unionization will speak a lot to how the hospital would like to move forward with its staff.”

A spokeswoman for George Washington University said the hospital is making gains in nurse retention and staffing, with less turnover and more new hires in the past year.

In 2021, the Foggy Bottom hospital and academic medical center, which is licensed for 395 beds, admitted more than 18,000 patients, logged nearly 47,000 emergency department visits and delivered about 2,500 babies, hospital data show.

DaSilva, the GWU OB/GYN resident physician, said that as part of the demands of an 80-hour workweek, residents also work at Holy Cross Hospital in Silver Spring, which hosts GWU physician residency programs. Holy Cross has one of the busiest labor and delivery units in the region and a largely Spanish-speaking population with many high-risk pregnancies.

On Thursday night, the 29-year-old Rhode Island native said she juggled five patients undergoing Caesarean sections, multiple patients in labor and new patients coming through triage.

“I joined this profession to provide high-quality care for my patients, and I just want to ensure that all patients are getting that high-quality care,” she said.