Labor analysts say doctors have jumped to the front of the line of healthcare workers forming unions while others in the medical field continue to show interest, including nurses at a hospital in the North Dakota region.

Nurses at the CHI St. Francis Health Breckenridge hospital along the border with Minnesota now have a collective bargaining unit.

Connie Okeson, a registered nurse at the hospital, said she hopes voting to form a union allows her team to illustrate staffing issues. She emphasized they have to fight to make health facilities in smaller towns and cities desirable places to work.

"A lot of new nurses, they're not interested in working in small towns because we don't have all the things they want to do in a hospital," Okeson pointed out. "It's more low-key. But I'm hoping by doing this that we can bring those ancillary services back. And then, maybe more nurses will want to work at St. Francis."

CHI leaders could not be reached for comment. Since coming out of the pandemic, labor organizing in health care has gained a bigger following. Nurses were among those leading the charge, but the Journal of the American Medical Association said the movement has caught on with physicians. Doctors led nearly 30 union drives the past two years, well above yearly averages the past two decades.

St. Francis Breckenridge is a 25-bed critical access hospital serving a handful of communities. Corporate consolidation remains a force within health care and Okeson noted nurses want to be part of the wave giving workers at not-so-big facilities a bigger voice.

"I'm hoping it opens it up for (workers at) other small hospitals to do the same," Okeson stressed.

She added having more input can improve patient care, aiding the reputation of small-town hospitals and making sure they stay on as a key employer for these communities. Negotiations involving her colleagues are expected to begin within the next six to eight weeks.

Kansas City transit riders and workers are fighting proposed cuts, warning of a looming public transit crisis.

Hundreds of advocates of the Kansas City Area Transportation Authority gathered on the steps of City Hall last week over threats to cut 13 bus routes, eliminate up to 175 transit jobs and shut down the Immigrant and Refugee Integration Services microtransit program.

Protesters warned the cuts could strand thousands, cost hundreds of jobs and leave misclassified IRIS drivers without unemployment benefits.

Ashley Ball, a leader with Stand Up KC and the Missouri Workers Center, relies on public transit for work.

"I was living in a hotel with my kids in North Kansas City and the buses weren't always reliable, so I got IRIS early to be able to get to my shift," Ball explained. "I work in the city now, overnights at Taco Bell. It's very beneficial to have IRIS when I get off work."

Supporters argued the cuts are needed to address KCATA's budget shortfall, as the city's $71 million allocation falls far short of the $117 million needed. Officials also cited high administrative costs and call for more efficient transit operations.

In 2024, KCATA reported 1.1 million riders, a four-year high, averaging more than 35,000 people daily. Couple that with KC Streetcars, and Kansas City's transit served more than 40,000 people per day last year.

For Ball, its significance goes beyond just transportation.

"Our public transportation is the heart of the city," Ball emphasized. "It allows us, no matter where we are from or what we look like, to move around, accomplish our goals and try to live a better dream."

The budget cuts are being discussed by the City Council Finance Committee after talks were delayed in a previous session.


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Minnesota's up-and-coming doctors say in order to better care for patients down the road, they need collective bargaining power.

A large group of them has filed to form a union, reflecting an industry shift. This week, a supermajority of nearly 1,000 University of Minnesota resident physicians and fellows submitted their union-creation plans. It follows a similar move by peers at Hennepin Health earlier this month.

Dr. Thomas Schmidt, infectious diseases fellow at the University of Minnesota, said the current work environment for providers advancing through their training in hospitals and other settings is pretty grueling, with up to 80-hour workweeks in some cases.

"It's us making sure that we're having some breaks and making sure that we're able to have some life outside of training," Schmidt explained. "To ensure that we can be good doctors when we're there with our patients."

Schmidt cited burnout, still lingering from the COVID-19 pandemic, as one factor behind doctors embracing unionization. Researchers say the number of newly union-represented doctors could soon double, compared with the past two decades.

Because of consolidation in health care, more physicians are now employees of larger systems, as opposed to independent practitioners. The university said it will be responsive to all necessary parties as the process takes shape.

Doctors still getting their training say the residency system leaves little room to advocate for changes or request a new location. And while established medical professionals might make good money, Schmidt said it is not the case for residents, who are often in the $15 to $20 per-hour range.

"That is not a substantial amount of money to be able to take care of your housing, to take care of your family," Schmidt pointed out. "I'm a parent of two young kids, so it has not been easy to be a trainee."

He added some peers are delaying starting a family because of the limited pay and long hours.

Skeptics fear the union push among doctors will reduce the earnings of specialists. Meanwhile, the Minnesota Association of Professional Employees, which has members working on infectious disease control in the state health department, recognizes the need for providers to have a bigger voice. It said it is vital as public health concerns, such as the bird flu, add to the work demands for the young professionals.

Overflow crowds are showing up at town hall meetings in Iowa, which had been planned to allow people to ask questions of their congressional representatives. But the lawmakers are not showing up.

Constituents are attending town hall meetings at libraries across the state to ask about potential changes to Social Security, cuts to government agencies - and rollbacks of Diversity, Equity, and Inclusion programs.

But Iowa American Federation of Labor President Charlie Wishman said U.S. Rep. Mariannette Miller Meeks - R-Davenport - and U.S. Rep. Zach Nunn - R-Bondurant - are among lawmakers who haven't shown up to listen.

"And if they don't show up, we still have crowds that are standing room only or overflowing," said Wishman, "just to try and talk to an empty chair."

Wishman said advocacy groups are trying to find other ways to connect people with their representatives - including by writing postcards or emails, or calling their Washington offices with questions about the Trump administration's effort to reduce spending and downsize the federal government.

The advisory group, the Department of Government Efficiency - overseen by SpaceX and Tesla CEO Elon Musk - has announced plans to terminate leases for seven federal office buildings in Iowa, including for the IRS, the Food and Drug Administration, and the U.S. Fish and Wildlife Service.

Wishman said the cuts mean terminating important positions for federal workers in Iowa.

"Bird flu people," said Wishman, "or they work at the disease lab up in Ames or, like, something that we really need staffed."

Wishman said since lawmakers didn't show up to the scheduled town hall meetings, attendees wrote their questions on postcards - which he says will be delivered to the congressional representatives' offices.