Essentia Health advanced practice providers move toward ULP strike vote

Advanced Practice Providers (APPs) at Essentia Health are being forced to take unprecedented action. For nearly a year, 400 APPs — who include nurse practitioners, physician assistants, Certified Nurse Midwives, and clinical nurse specialists — have requested a seat at the bargaining table. Essentia Health has refused and instead responded with numerous illegal Unfair Labor Practices.

As a result of these Unfair Labor Practices, Essentia’s East Market Advanced Practice Providers are now moving to authorize an Unfair Labor Practice strike vote. The vote will take place Monday, June 23. Several other bargaining groups within Essentia Health have also announced Unfair Labor Practice strike votes in recent days. Acute Care nurses with Essentia Health and newly organized clinic nurses also announced plans for a ULP strike vote last Wednesday.

APPs have faced repeated Unfair Labor Practices from Essentia Health including retaliation, intimidation and illegal conduct, denying basic union rights inside the facilities. Additionally, Essentia Health has made numerous changes to the schedules and assignments of these professionals.

It is unfortunate because APPs are an essential part of today’s healthcare ecosystem. In many cases, they are the primary medical professionals patients interact with, particularly in rural or high-volume hospital settings. Yet despite their critical role, Essentia administrators have refused to meet even one time with APPs to discuss the basic conditions necessary for providing safe patient care.

“Patients don’t always know whether they’re seeing a doctor or an APP. That’s because our care is that comprehensive,” said Neissa Boehm, an APP at Essentia. “But behind the scenes, we’re being excluded from the conversations that determine how we can provide that care in a way that is best for both patients and providers.”

Key concerns APPs want to negotiate on include unsustainable staffing models, corporate interference in clinical decision-making, and the hospital system’s enforcement of restrictive noncompete clauses that prevent providers from continuing to serve their communities if they leave Essentia. Yet, due to Unfair Labor Practice violations, APPs cannot meaningfully engage in conversations with Essentia.

In 2024, APPs at Essentia voted overwhelmingly to unionize, and the National Labor Relations Board certified that result. By refusing to bargain, Essentia isn’t just ignoring the voices of frontline providers, they’re violating federal labor law.

“We’re not asking for luxury,” said Sara Feldbrugge, an APP at Essentia. “We’re asking for the respect and autonomy to care for people properly and the basic right to speak up without risking our jobs.”

APPs are acting out of necessity. Essentia’s refusal to engage and multiple Unfair Labor Practice violations leaves them no choice but to prepare for the possibility of a strike. Because when corporate executives avoid the bargaining table, frontline healthcare professionals are forced to take action. And when the people delivering care are ignored, patients suffer the consequences. – Minnesota Nurses Association press release