© 2025
Local NPR for the Cape, Coast & Islands 90.1 91.1 94.3
Play Live Radio
Next Up:
0:00
0:00
0:00 0:00
Available On Air Stations

Physician assistants, midwives, nurse practitioners seek to join Cape Cod nurses' union

The entrance to Falmouth Hospital is illuminated against a cloudy evening sky, Aug. 13, 2025.
Jennette Barnes
/
CAI
The entrance to Falmouth Hospital is illuminated against a cloudy evening sky, Aug. 13, 2025.

Nurse practitioners, physician assistants, and certified nurse midwives at Cape Cod Healthcare are considering unionizing.

A majority of those workers, known as advanced-practice providers, have signed union cards requesting a vote on whether to join the Massachusetts Nurses Association, the same union that represents registered nurses.

Jacklyn Reis, a physician assistant in the Falmouth Hospital emergency room and urgent care, said overtime pay has been eliminated for salaried employees who stay late on a shift.

“I came from a large metropolitan area, from a Level 1 trauma center, and was promised certain working conditions and certain compensation and benefits packages, and within four months there, it was completely and unilaterally changed on me,” she said.

Cape Cod Healthcare employs 193 advanced-practice providers, according to the Massachusetts Nurses Association.

Association spokesperson Joe Markman said the union does not make public the number of employees who signed union cards, but he said it was sufficient to file with the National Labor Relations Board Aug. 8.

“We do not file unless we are confident the providers will win their election,” he said.

He said he anticipates the new group will have a separate bargaining unit — not the same unit as the registered nurses — but the National Labor Relations Board makes that decision.

Reis said the providers have additional concerns beyond pay.

She said Cape Cod Healthcare wants workers to use its own providers for their health care, and if they don’t, they will pay higher co-pays and fees. That can be a privacy issue, she said.

Cape Cod Healthcare refused to answer specific questions, including questions seeking to confirm the accuracy of the employees’ complaints.

The health system provided a written statement saying the notice it received from the Massachusetts Nurses Association did not specify the locations where the employees work, and the union only gave Cape Cod Healthcare until 5 p.m. the same day to respond.

Markman said the National Labor Relations Board filing went to Cape Cod Healthcare as an organization, and it included all full-time, part-time, and per diem nurse practitioners, physician assistants, and certified nurse midwives.

“Even after filing for an election we are still open to discussing [voluntary] recognition if CCH would like to reach out to us,” he wrote in an email.

Cape Cod Healthcare said it respects the right of employees to choose whether or not to be represented by a union. It said a secret ballot supervised by the NLRB “is the best process for employees to become informed regarding this important decision and to express their view.”

Employees do not want a conflict with the hospital administration, Reis said.

“None of us are looking to fight with [the] administration or with the Cape Cod Healthcare system,” she said. “We're just looking for more of a voice and more of a say to advocate for ourselves and our patients.”

The National Labor Relations Board will supervise a formal vote. No date for the vote has been set.

Advanced-practice providers’ effort to unionize comes as registered nurses are struggling to reach a new contract with Cape Cod Healthcare. The nurses authorized a three-day strike if the two sides cannot agree.

Jennette Barnes is a reporter and producer. Named a Master Reporter by the New England Society of News Editors, she brings more than 20 years of news experience to CAI.