A successful union vote last month at the Miles City hospital could help employees at a sister facility in Billings unionize.

Registered nurses at St. Vincent Healthcare think they have enough support to join the Montana Nurses Association, a union that represents about 15 percent of the state's 15,000 nurses.

Almost 60 percent of eligible nurses at St. Vincent have signed cards asking for a union vote, said Curt Jensen, an emergency department nurse who has led organizing efforts.

"We're at about a 98 to 99 percent positive response," Jensen said. "Everyone keeps saying, 'Why can't we vote now?' "

Organizers will ask the National Labor Relations Board to hold an election at St. Vincent at the end of the month, Jensen said. Only 30 percent of eligible employees must sign cards before an election can be held.

Depending on which departments are included, 350 to 500 St. Vincent nurses could vote. A simple majority is needed to establish an MNA local.

The vote would come on the heels of a similar election at Holy Rosary Healthcare in Miles City. Nurses there voted 53-21 in July to join MNA.

Nurses at a third sister hospital, St. James Healthcare in Butte, are also represented by MNA. The three facilities are operated by the Sisters of Charity of Leavenworth.

Holy Rosary nurses hope that being unionized will give them more influence with hospital decision-makers.

"It will help with staffing and patient care," said Jim Keith, who has worked at Holy Rosary for four years. "That's what it all comes down to is good care for our patients."

Brent Certain, an emergency department nurse who has worked at Holy Rosary for 20 years, said nurses want to have a voice in the conversation about health care reform.

"There are huge changes coming in health care," Certain said. Nurses want "to have a voice at the table and be heard, to direct our own future. We've never had a voice in the ultimate decisions. We could express our opinion, but we never really had a seat at the table. Now we do."

Officials at both hospitals have said unions are unnecessary.

"We are continually working to respond to the changing world of health care," St. Vincent's chief nursing officer, Roxanne Olason, said in a statement this week. "Over the past 12 months, working together with our nurses, St. Vincent Healthcare has experienced no nursing layoffs, no decrease in benefits, and, in fact, has been able to provide appropriate increases in pay."

Olason said the hospital has also instituted several changes that benefit nurses, including:

• Putting in place additional nurse and nurse director positions.

• Beginning nursing open forums to interact with nursing leadership.

• Replacing temporary traveling nurses with permanent registered nurses.

• Instituting "daily huddles" to improve communication and the flow of patient information.

• Adding a registered nurse with a doctorate to the hospital board of trustees and to the quality and patient safety committee of the board.

Contact Diane Cochran at dcochran@billingsgazette.com or 657-1287.