It's Thursday, December 4, 2025.

After a delayed vote because of the government shutdown, hundreds of nurses at four UnityPoint hospitals in the Des Moines area are voting this weekend on whether to unionize with Teamsters Local 90—an election being closely watched by non-union nurses across Iowa who are also struggling with understaffing and patient violence.

The postponed UnityPoint vote among 1,776 health care professionals at Blank Children's Hospital, Iowa Lutheran Hospital, Iowa Methodist Medical Center, and Methodist West Hospital has been rescheduled for Sunday, Dec. 7, through Tuesday, Dec. 9.

It's the state's largest private-sector union election ever, according to Teamsters.

"I'm excited. I'm ready to vote," said Belinda Carpenter, a registered nurse in the critical care and emergency departments who works at the three adult hospitals. "I think that nurses are seeing the bad side of what UnityPoint's doing."

Belinda Carpenter, left, and Whitney Armstrong, right, appear in a screenshot from a video call with Iowa Starting Line’s Amie Rivers. Both are registered nurses at UnityPoint hospitals in the Des Moines area and helped organize 1,776 nurses across four hospitals. (Amie Rivers/Iowa Starting Line)

That "bad side," according to nurses who spoke with me, is relentless cost-cutting at the expense of workers and patients: Nurses have seen their pay shift differential cut, meaning they're working more hours for less money. Longtime nurses get burned out, leave, and aren't replaced—meaning patient wait times go up, increasing frustration and angry outbursts.

Carpenter recalled a time a colleague was assaulted by a patient and broke their back. UnityPoint, she said, disciplined them when they were unable to return to work because of the pain.

"That type of stuff is the stuff that's super disappointing, because I thought better of this company," she said.

Even patient equipment has become substandard, said Dawn Balek, an overnight recovery room nurse at Iowa Methodist Medical Center with nearly 18 years of nursing experience.

"They don't ask us which would work better; all of a sudden, we get new IV bags," Balek told me. "We go to the cheapest tubing, and it falls out ... We're constantly telling them there's a problem; they don't care, 'cause they're saving money."

Dawn Balek, an overnight recovery room nurse at Iowa Methodist Medical Center. (Courtesy of Dawn Balek)

UnityPoint has opposed the unionization effort from the beginning. Workers say the company has paid anti-union consultants up to $6 million over the past year to fight it—including creating a video series that features two of the company's chief nursing officers encouraging workers to vote no.

"At UnityPoint Health, we believe that direct collaboration is the foundation for building the strongest and most supportive environment for both our team members and the patients we serve," the company said in a statement, adding a union was "not in the best interests of our patients, our nurses or our community.”

Whitney Armstrong, a critical care nurse at Iowa Methodist Medical Center, scoffed at the "direct collaboration."

"We don't have a say in anything as it is," she said.

The mere threat of a union, nurses said, has prompted welcome changes. Carpenter noted that metal detectors have been added to emergency rooms. Balek said nurses from different floors are talking more with one another about their issues.

Armstrong believes the union's demands—if they win, and then get safe staffing added to a contract—will actually help the company's bottom line.

"Safe staffing actually saves money for the hospital," she said. "The length of stay gets decreased because patients are able to get better faster. And it's better for nurses—it decreases burnout, it makes us wanna stay in our job, it means people don't leave the bedside. So all of these things create such a net positive for the community."

Are you working in health care? What concerns do you have about your working conditions? Email me.

Amie Rivers

Newsletter Editor, Iowa Starting Line

Member, COURIER United (WGA East)

Email me

2 Iowa Starbucks stores join escalating national strike: Two of Iowa's four unionized Starbucks locations joined a national Starbucks Workers United escalating strike today. Starbucks workers at the Des Moines and Iowa City stores walked out Thursday and are asking the community to join them in picketing, boycotting Starbucks until workers get a contract, and demanding the company bargain in good faith. The strike began Nov. 13 and has grown each week. Baristas will be picketing from 7:30 a.m.-12:30 p.m. each day. Community members are invited to join the pickets, or bring hot food, hot drinks, and hand warmers to the strike line as bitterly cold temperatures have descended upon the state.
Fewer jobs nationwide: Small businesses—those with fewer than 50 workers—cut 120,000 jobs across the US in November, surprising economists (but not regular people paying attention).
Worse than Scrooge? After being bought by a private equity firm, Walgreens will no longer give workers paid time off for six major holidays, including Christmas, leaving workers scrambling. (Even Ebenezer Scrooge gave Bob Cratchit Christmas off with pay!)
How much would your ACA insurance premium rise if premium tax credits aren't approved by Congress this month? Use this calculator to find out.
Is China really buying all the soybeans Trump said they would? Not right now, they're not!
Union endorsements: The Heat and Frost Insulators Local 39 in Council Bluffs and Omaha endorsed state Rep. Josh Turek for US Senate. "He’s been a fighter for the working class during his time in the state legislature and we know he’ll take that same fight to Washington," said Local 39 business manager John Hanson. // The Heat and Frost Insulators Local 81 in the Quad-Cities endorsed state Sen. Zach Wahls for US Senate. "He’s been a consistent advocate for labor—someone we can count on to protect our right to organize, stand up for safe jobs, and defend fair wages and benefits," said Local 81 business manager Sean Nagle. // The Communication Workers for America Local 7102 endorsed Jennifer Konfrst for US House District 3. "She’s been a strong voice for unions and working people, and she’s ready," said Local 7102 secretary-treasurer Mark Rocha.
Voting on a union: The postponed UnityPoint vote among 1,776 health care professionals at four Des Moines hospitals on whether to join Teamsters Local 90 has been rescheduled for Dec. 7-9. // Forty full- and part-time drivers and monitors at Durham School Services in Urbandale have filed a petition to unionize with Teamsters Local 90.

All information taken from Iowa Workforce Development's WARN Act website. Read WARN Act and Iowa WARN Act criteria here.

Wells Fargo in West Des Moines is laying off one worker by Dec. 12, 63 workers by Dec. 26, 26 by Jan. 2, and 14 by Jan. 23.
Insane Impact in Des Moines is closing and laying off 90 workers by Dec. 17. However, the company told the Des Moines Register they were being acquired by Musco Sports Lighting and offered all workers roles with the new company, which will remain at the location. Read more here.
Networking Imaging Solutions in North Liberty is closing and laying off 140 workers by Dec. 18. Read more here.
Superior Tube Products in Davenport is closing and laying off 26 workers by Dec. 19. Read more here.
Bauer Built Manufacturing in Paton is closing and laying off 62 workers by Dec. 31.
Mason City Clinic in Mason City is laying off 147 workers by Dec. 31. Read more about a potential WARN Act violation here.
RELCO in Cedar Rapids is closing and laying off 34 workers by Dec. 31. Read more here.
RTX in Cedar Rapids is laying off three workers by Dec. 31.
Toyota Financial Services in Cedar Rapids is closing and laying off 54 workers by Dec. 31. Read more here.

The landscape for local news is shifting fast. At Iowa Starting Line, our commitment to you—and to Iowa—hasn’t changed.

Our end-of-year fundraising drive runs through Dec. 16, and your support keeps this work strong.

Your contribution helps us shine a light on the decisions, debates, and leaders shaping Iowa's future. We can’t do this work without you.

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Thanks for reading. This newsletter was written by Amie Rivers. It was edited by Paula Solis.

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