In the world of union organizing, 275 workers isn't a big campaign. That is, unless they're registered nurses working for a private-sector hospital, a group that isn't organized anywhere in Texas, at least for now.

The city's huge medical community is watching closely to see whether nurses at Cypress Fairbanks Medical Center Hospital vote this week to join the California Nurses Association's National Nurses Organizing Committee.

The union, which despite its name represents 80,000 nurses nationwide, moved into Texas last year and launched an organizing drive at the Tenet Healthcare-owned hospital. If CNA wins, the hospital would be the first in Texas whose nurses would be represented as a group by a union, according to officials from the Texas Hospital Association.

Two nurses who are supporting the union say the campaign is more about patient-care concerns than wages or benefits. In fact, said Jeanette Thornhill, the hospital is "truly a wonderful place to work" and the wages, which range from about $27 to $33 an hour, are good.

While they want guaranteed wage increases, higher on-call pay and a pension plan beyond the hospital's 401(k) program, the focus is more on higher nurse-to-patient ratios.

"We want a voice at the table when health care decisions are being made," said Christopher Williams, a fellow registered nurse who works in the heart-monitoring unit with Thornhill. "We want to be advocates for our clients — our patients."

While the hospital said it's up to its employees whether they want a union, it's less than than enthusiastic about it.

"Cypress Fairbanks Medical Center believes that the need for unions is unnecessary, and it would be best for management and employees to continue to work together without the involvement of a union," a Tenet statement said. "The hospital offers competitive wages and benefits, and management promotes a positive and friendly work environment."

CNA's organizational success rate is about 80 percent, said A. Kevin Troutman, an employment lawyer with Fisher & Phillips in Houston who specializes in union issues on behalf of management. The union doesn't pick targets without doing a lot of research and, if it doesn't think it'll win, it usually won't hold the election.

Troutman speculates that if CNA wins, it will begin organizing other Tenet-owned hospitals in Houston, including Park Plaza Hospital.

"They're probably salivating on the potential of entering the Medical Center," said Troutman, who has no connection to either side. "Once they have their foot in the door, it will be hard to fend them off if you are a hospital looking for union-free status."

29,000 nurses in Harris

The Texas Hospital Association contends if employers are doing everything right, "you don't need a third party like a union," spokeswoman Amanda Engler said.

The Texas Medical Center is watching the vote but doesn't plan to address the matter, spokesman Harry Holmes said.

E. Dale Wortham, president of the AFL-CIO of Harris County and a board member of the Harris County Hospital District, said the issue has gotten hospitals' attention.

"I can tell you the Texas Medical Center and all the member institutions are as nervous as house cats in a room full of rocking chairs," he said.

Opposition formed

But it couldn't because of the union's neutrality agreement with Tenet, said Brown, who estimates there are 20 to 25 core members in her group. To get around the restrictions, the group held a "truth-a-thon" rally outside the hospital and passed out brochures.

Brown said she opposes the union because it's not offering anything new.

"We can speak for ourselves," she said.

Management has an open-door policy, and it works, said Brown, who said she has popped into the chief executive's office and has sent e-mails about concerns she's had. The CEO also holds forums where he answers questions, and a staff nurse council meets once a month.

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