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More Portland-area medical providers voted this week to unionize, as the Oregon Nurses Association continues to expand its ranks in the Legacy Health System.
About 120 advanced practice providers—a diffuse group that includes some nurse practitioners, physician associates and midwives, among others—will join the union, after an overwhelming majority favored the move in votes tallied Tuesday.
The workers, known by the “APP”” acronym, work in diffuse roles across the Legacy Health System, in several different hospitals and clinics.
“A patient who interacts with Legacy at any level is likely to receive care from an APP since we make up about one-third of the providers here. But sometimes it feels like we are a hidden workforce,” said Beth Alston, an advanced practice provider at Legacy Health, in a written statement sent by the association. “We decided to form a union because we are siloed in our work areas and Legacy doesn’t have an organized APP leadership structure where our concerns are taken seriously.”
Legacy did not respond to an email seeking comment.
After a recent unionization push, Oregon Nurses Association membership within Legacy Health has dramatically increased. The union now says it represents some 3,200 “frontline healthcare workers”—spread across 10 bargaining units—who are in negotiations for first contracts with Legacy. An additional 400 registered nurses are trying to secure successor contracts, the union said.
The ONA’s growth in the Legacy system followed Oregon Health & Science University’s announcement in 2023 that it intended to buy Legacy, a deal that collapsed in May.
The new APPs will not all be part of the same bargaining unit. Some Legacy APPs were already unionized, and a subset of the roughly 120 new members will join an existing bargaining unit, while the rest will join a separate one, said Myrna Jenson, an ONA staffer, in a phone interview.
Of the newly unionized group, the larger subset had 90 eligible members, and voted 59-6 to join the Oregon Nurses Association, according to the National Labor Relations Board.
The second group of APPs, which focuses on pediatric medicine, had 34 eligible voters. It voted for unionization by a vote of 20-1.