Once there’s strong support, healthcare workers begin collecting union authorization cards. Before signing, make sure all your questions are answered and you’re confident in your decision to support union representation. Signing a card doesn’t make you a union member and doesn’t mean you’ll pay dues. Your employer cannot see the cards; they’re completely confidential.

Once a strong majority of your colleagues have signed cards, they’re submitted to the National Labor Relations Board (NLRB) — the federal agency that oversees union elections. A formal, secret-ballot election is then held. Your vote is private — your employer will never know how you voted. Union representation begins once a simple majority (50% plus one) votes YES to unionize. In some cases, if enough cards are signed, a vote may not be needed.

Some rights and protections are in place right away – even before contract negotiations begin. Once you win your union election, your employer may not change current practices without negotiating with you first. You and your colleagues will distribute bargaining surveys and attend meetings to determine what the priorities should be in negotiations. In a democratic process, you will choose your Bargaining Team — fellow Union members at your hospital who will work side-by-side with the union’s professional negotiators and organizers and sit across the bargaining table from management’s representatives. The final agreement must be approved by a majority vote before it takes effect (and before anybody pays dues).