Have you tried to make an appointment with your doctor, only to be told your trusted doctor—to whom you have bared your soul, not to mention the more intimate parts of your body—doesn't have any openings in the next month, but a physician's assistant you've never met could see you next week? Did your doctor retire—months ago—and you still don't have a doctor because nobody is accepting new patients right now? If you did get an appointment, how long did it last? Did the doctor spend more time looking at the computer than you? Have you gone in for a test you've been getting at your doctors' office for years, only to be told you can't get that test here anymore, but it is now available in our expensive new facility? Are you still waiting for that refill request?

Some people get mad at their doctor when they experience these frustrations, but doctors have surprisingly little control over how the clinics in which they practice are run. I learned that by working as a nurse in a primary care clinic.

It was my first job after graduating from nursing school, and I loved it. I admired the doctor I worked with and grew fond of the patients in our care. But after a few years on the job, I received a letter from Jefferson Healthcare management telling me the kind of work I do and even the location where I worked was changing—whether I wanted it to or not. Management had outsourced leadership to a consulting firm, which was now fundamentally altering the relationship between doctors and patients. The doctors I worked with used to see about 12 patients a day. The consultants said we had to see 18-22 and they lingered outside exam rooms with stopwatches, listening to patients talk to their doctors and nurses. They said I needed to rejigger the doctors' schedules so that patients were increasingly likely to be offered an appointment with any provider who had an opening, rather than the doctor they knew and trusted. Primary care felt less like a traditional doctor's office and more like a walk-in clinic. Nurses were shuffled between clinics as if they were interchangeable. A nurse who hadn't seen a delivery room since nursing school could find herself working with mothers and babies, as if her training and experience didn't mean anything.

As my workplace conditions deteriorated, I got interested in learning more about the union. I hadn't taken a job at Jefferson Healthcare with a mission to make it a better place to work, I was just glad I had a living wage job in Port Townsend. I had a vague idea that a job with union representation was a better job, but I wasn’t exactly sure why. I knew that Washington is an “at will” employment state, where workers without a contract can be fired without notice or explanation. I figured having a union contract was worth my dues and I didn’t think much more about it.

Fortunately, workers benefit from unions whether or not they are active members. In fact, wages for all workers are better in parts of the country with a higher percentage of union representation. I learned that the union representing workers at Jefferson Healthcare, UFCW 21, is the largest private-sector union in Washington, with about 44,000 members. About a third of those members are in health care. Historically, unions have supported workplace improvements for all workers, like increased safety, ending child labor, and limiting working hours. The campaign for better working conditions continues. Last year, for example, UFCW 21 supported the initiative to increase the minimum wage in Washington and provide all workers with paid sick leave.

So, even though I didn’t know it, my union was already working for me. I starting getting more involved with the union after the changes in the clinics and I joined with more experienced stewards to help negotiate a new contract. We agreed with Jefferson Healthcare to wage increases, rejected a proposal to limit how workers earn paid time off, and agreed to daily overtime in our clinic contract. Perhaps most important to me, we added restructure language to our contract to prevent the kind of arbitrary reassignment that got me interested in the union in the first place. There were many changes to the clinics that were beyond the scope of our contract, but it was heartening to see how employees working together could negotiate for change. I hoped the doctors would be heartened by our success and get themselves organized too.

My involvement with the union could have ended there. With the help of my co-workers and the expert negotiator from UFCW 21, I had gotten more than what I had ever hoped. It turned out that was just the beginning, because I benefited in unexpected ways. For example, the relationships I developed, not only with my coworkers, but also by meeting folks in the larger community who are also represented by UFCW 21. (That includes the workers at QFC, Safeway, plus city and county employees.) I’ve gained a better understanding of the work that other people are doing at Jefferson Healthcare, and a better understanding of the issues at stake for the future of our rural hospital.

I also started following the activities of the public hospital district commissioners. I was surprised that some commissioners appeared to take a very passive approach to the oversight responsibility of their position, even going along with CEO Mike Glenn when he lobbied politicians to oppose worker protections supported by the Washington State Nurses Association. They seemed oblivious to the changes in primary care, probably, I thought, because they received regular reports from management, but set aside no time in their meetings to get reports from labor representatives. I came to realize that the commissioners have important work to do that affects access to healthcare for everyone in Jefferson County. It really matters who holds those offices.

Many excellent folks continue to work diligently for patients at Jefferson Healthcare and they are represented by a union that has endorsed Cheri Van Hoover to help protect the public interest in our hospital district. Think of that the next time you are trying to figure out what number to push to try and speak to a live person at your doctor's office.

There are a lot of great reasons to vote for Cheri to be a Public Hospital District Commissioner, but this my story of how I got interested in her campaign and an important reason why I will be voting for her as soon as I get my ballot.