For a year and a half, a group of nurses at St. Mary Medical Center in Langhorne met with management to share their concerns about the cuts they had seen over the last few years — to staffing, on-call pay, sick leave. The quality of care, the nurses believed, had taken a hit.

When nothing changed, they contend, they decided to unionize.

Eight months after those initial organizing talks and a process marked by fierce anti-union activity at the hospital, nearly 800 nurses at St. Mary have voted to join the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP). It’s one of the largest successful union campaigns in the Philadelphia region in the last few years.

“This was never about money,” said Donna Halpern, a 57-year-old nurse in the cardiac critical care unit. “I want to be able to go and care for my patients within the scope of my license ... and not have to worry about which patients get 100 percent of my care.”

The vote, tallied Friday, was 403-285.

The organizing victory could have ripple effects throughout the region, as St. Mary is one of five hospitals in the Philadelphia area owned by Trinity Health. The others owned by Trinity, one of the country’s largest Catholic health systems, are Mercy in West Philadelphia, Mercy Fitzgerald in Darby Borough, Nazareth in Northeast Philadelphia, and St. Francis in Wilmington.

Mercy Fitzgerald, organized by PASNAP in 2000, is the only other unionized Trinity hospital in the area. PASNAP tried to organize Mercy but lost the election in 2016.

Trinity, a not-for-profit based in Livonia, Mich., owns 92 hospitals in 22 states. Just 4% of Trinity’s 133,000 staffers are unionized, according to a January 2019 company document.

“The election gave nurses the right to choose whether to work directly with nursing leadership as they have in the past, or to have PASNAP act as their exclusive agent on issues of pay and benefits,” Trinity spokesperson Ann D’Antonio said in a statement. “Nurses were split on the issue, with strong feelings on both sides, but by a 58% to 42% margin, voters chose to change the historical relationship and let PASNAP be their negotiator.” She said there are “still legal issues to resolve that could alter that outcome."

>> READ MORE: In a rare move, workers at 6 low-income health centers in Philly vote to unionize

In 2018, Trinity reported $55 million in profit at St. Mary on its audited financial statement. That’s down from the $65 million it reported in 2017, but higher than the $48 million it reported in 2015.

The St. Mary campaign comes three years after PASNAP, an independent union launched in 2000, saw a wave of successful organizing campaigns, adding 3,000 nurses and techs to its membership rolls at a time when most unions in Philadelphia and nationally were stagnating. The period of organizing gains was capped with controversy in 2017, as the union’s former executive director, Bill Cruice, and two employees were found to have “misappropriated” nearly $330,000 over five years.

PASNAP has about 9,000 members, though it is slated to lose about 800 due to the closure of Hahnemann University Hospital.

>> READ MORE: Steeper losses from fired exec. director at PASNAP nurses union

A visit from the ‘union busters’

Nurses at St. Mary first started talking with PASNAP in 2016 during the union’s series of organizing wins, but the conversations went nowhere. Three years later, believing that conditions at the hospital showed no signs of improving, a group of nurses started discussing unionizing over meetings at the home of Joe Gentile. Gentile, a 62-year-old who said he feels like “everyone’s dad" at the hospital because he’s been there for his entire 35-year career, said his wife told him, “Why are you doing this? Shut your mouth, keep your head down, retire in four years.”

>> READ MORE: From 2016: Why more nurses are unionizing in Phila.

He knew he’d be putting his career on the line to lead an organizing campaign: Who would hire a 62-year-old nurse who’s only ever worked at one hospital? But, he said, he believed he couldn’t stay quiet. He had recruited many nurses over the years and felt responsible for them. He said he couldn’t bear to see his coworkers be put in dangerous staffing situations.

He said he told his wife, “I have to do this.”

Shortly after the nurses made their union drive known to management in April, consultants from Yessin & Associates, a Tampa, Fla.-based company, showed up. Led by lawyer Brent Yessin, whom Bloomberg once described as “Rand Paul’s favorite union buster,” the firm has taken on PASNAP before and successfully stopped two campaigns, including the one at Mercy.

>> READ MORE: Here’s what happens when a union hospital merges with a nonunion hospital

Yessin & Associates held one-on-one meetings with workers who were on the fence about the union and spread rumors about the union’s plans, said Gentile and Halpern.

Fliers appeared around the hospital with photos of Gentile and his identical twin, nurse Jim Gentile, suggesting that the brothers were paid operatives of the union. “Are the Gentile Brothers Being Paid to Disrupt Our Hospital?" the poster read. “Ask Joe and Jim if they’re being paid to foment division at our hospital!”

“Nurses don’t use the word foment,” Gentile said, citing the “lawyer language” as a giveaway that it didn’t come from coworkers.

The Gentiles were never paid by the union to organize, PASNAP said.

Trinity declined to confirm that it had hired Yessin.