The Hawaii Nurses’ Association is at an impasse with The Queen’s Medical Center since the employer filed an appeal with the National Labor Relations Board — a closely watched move that could provide insight into relations between unions and employers under the Trump administration.
HNA says the majority of the Queen’s therapists, about 65, recently voted to become part of HNA, which was certified by the NLRB. But HNA says Queen’s, to date, has declined to bargain with the therapists.
Queen’s said in a statement that it has filed an appeal with the board in Washington, D.C., and declined to comment further.
Jonathan Leibowitz, HNA’s field services director, said he does not recall an instance in recent Hawaii history where an employer has refused to bargain with employees after the NLRB election process.
Upon certification, HNA said, employers generally negotiate with the newly unionized members and have a legal obligation to do so, regardless of whether there is an appeal. Some grounds for filing an appeal include allegations of defective election procedures, insufficient notice or objections to the makeup of the bargaining unit.
At the same time, both parties are aware the national board has no quorum, putting all such decisions in a holding pattern.
“We believe what they’re doing is using the appeal process in bad faith to simply avoid their obligation to negotiate,” he said.
The NLRB is an independent federal agency that enforces the National Labor Relations Act, with regional offices throughout the U.S. that are still able to conduct business and certify elections. But the board in Washington, which hears all appeals on union elections and unfair labor practice charges, currently does not have the three-person quorum it needs to function.
Raymond Catania, a board member of the Hawaii Workers Center, said, “I’ve been watching these developments and I’ve been very concerned.”
The Trump administration has signaled its opposition to unions, he said, particularly when the Department of Homeland Security in March ended collective bargaining for Transportation Security Administration officers and canceled their existing agreement.
The fact that the national NLRB does not have quorum means these cases “can just drag on forever,” and he is concerned that the current dismantling of the board will lead to the erosion of workers’ constitutional rights.
Respiratory therapists
Respiratory therapists at Queen’s, meanwhile, say they want union recognition to address staff shortages and wages.
According to HNA, the therapists in February presented Queen’s with their signed union-authorization cards, saying they wanted to be represented by the union.
Employers can voluntarily recognize a union based on these cards, HNA said, but Queen’s declined to do so.
The workers then file a petition with the NLRB to hold an election. HNA said Queen’s challenged the petition, and after a hearing the regional board ruled it could go forward.
The therapists held an election in April, with more than 90% voting to join, the union said. With a majority vote, the union is certified as representing the workers.
Respiratory therapists specialize in diagnosing, treating and managing breathing disorders, and at a Level 1 trauma center such as Queen’s, often work side by side with doctors and nurses in ICUs and emergency rooms.
There is a shortage of respiratory therapists nationally, including in Hawaii.
Pi‘ilani Akau, a respiratory therapist at Queen’s, said as a Level 1 trauma center, wages there are not competitive with other facilities. Additionally, she is concerned about having adequate staffing to meet patients’ needs.
“I believe all the respiratory therapists are very proud of what we do,” she said. “We like to provide good patient care, and I don’t think they (management) can see how important it is for us to make sure we have safe staffing conditions, because a lot of times, they’re not working beside us.”
HNA said the respiratory therapists recently attempted to join a bargaining session scheduled by radiation therapists, which they feel makes sense because their jobs are technical. But Queen’s management declined to talk with them until a decision on the appeal is made.
In response to questions about the situation, Queen’s Chief Operating Officer Darlena Chadwick said, “The Queen’s Medical Center appreciates the inquiry and QMC has chosen to exercise its right to file an appeal from the National Labor Relations Board Regional Director’s Decision and Direction related to the QMC Respiratory Therapists. As the appeal is pending at the federal level and until a decision has been issued on the appeal, QMC is not able to comment at this time.”
New precedent
HNA OPEIU Local 50, which represents 4,000 health care workers at major hospitals throughout the state, is concerned about whether these moves to appeal will be a new tactic by employers.
Whereas workers previously sought union representation and went through elections without issue, HNA said it is now encountering pushback every step of the way.
The union and Queen’s in January appeared to be on good terms, agreeing on a new contract for nearly 2,000 registered nurses, averting a strike in the final hours.
More than a dozen other health care workers it represents are facing the same dilemma, including seven clinical documentation improvement nurses at Queen’s and seven lactation consultants at the Kapi‘olani Medical Center for Women & Children who have voted to join the union.
Both employers have challenged the elections and refused to bargain until their appeals have been decided, HNA said.
HNA has filed unfair labor practice charges against both hospitals at the regional level for refusing to bargain, while urging them to “do the right thing” and respect employees’ rights to organize and bargain collectively.
Kapi‘olani declined to comment while the matter is under NLRB review.
“One of the things we have a big concern about, too, is just looking at the impact this can have on the rest of working people in Hawaii,” said Leibowitz.
Unions and employers are watching developments closely.
Union labor is a force to be reckoned with in Hawaii, which was one of two states with the highest union membership rates in the U.S. in 2024.
Hawaii had an average rate of 26.5% — an estimated 147,000 union members out of 556,000 wage and salary workers — according to the U.S. Bureau of Labor Statistics. The other state is New York, which had an average rate of 20.6%.
Recent strikes by hotel workers and nurses after lengthy and sometimes contentious negotiations in the past year have yielded contracts with higher pay and benefits.
That was before changes to the NLRB, which is currently hobbled by having only two members, without the three-member quorum needed to conduct business.
An ongoing legal battle over the removal and reinstatement of NLRB member Gwynne Wilcox has yet to be determined, leaving the board without the ability to issue decisions. As of Friday, Wilcox had not been reinstated.
The NLRB’s Office of Congressional and Public Affairs did not immediately respond to questions on the status of the board.
The last time the NLRB was without a quorum was from 2012 to 2014, and left hundreds of cases unresolved and disrupted workers’ rights to organize and bargain collectively, according to the Congressional Progressive Caucus Center, a Washington, D.C.-based nonprofit.
