Morisha Moore was running errands in Wilkinsburg when the two nurses approached her. Both wore scrubs to identify themselves and carried yard signs to hand out while canvassing the diverse neighborhood. They spotted Moore pushing her baby daughter in a stroller, which doubled as a shopping cart and was piled with goods such as a 20-roll pack of paper towels. The young mother was a perfect candidate for their community engagement efforts.
The slogans on the yard signs read, “Pittsburgh Stands With Magee Nurses,” “Elevating Women’s and Family Health for Our Region” and “United for Our Patients.” Each displays a QR code that leads to a community survey from newly unionized nurses and advanced practitioners at UPMC Magee-Women’s Hospital — where nearly half of all babies born in Allegheny County each year are delivered.
Magee nurses — who voted to unionize in August — believe their cause is tied up with those they serve and seek to bring the public along as they negotiate their first contract with UPMC. “It’s important that your input is included in this process,” the nurses wrote in a letter to the community on the survey’s landing page. Their outreach includes billboards around the city, social media, word of mouth and canvassing in specific neighborhoods to reach underserved groups.
We’re “trying to make things better and have better outcomes” for “women, families and babies,” obstetrics nurse Gretchen Zelinsky told Moore. Would she be willing to fill out the survey to share her experiences as a patient with the union?
“I’m all for that,” said the 32-year-old Wilkinsburg resident, who delivered all five of her children at Magee. The youngest was in the stroller, sheltered under its canopy on an unseasonably warm and sunny day in March.
Moore had watched one of her cousins suffer through a stillbirth at the facility and is well aware of the high risks she and other Black birthing people face in Allegheny County. (Pittsburgh’s Black maternal mortality rate was higher than rates in 97% of similar cities, according to a 2019 report by the city’s Gender Equity Commission.) She took a sign to plant in her yard and pledged to fill out the survey and share it with those in her social circle.
The union’s novel effort to inform bargaining is paying off: More than 800 people have filled out the survey as of early April. The response rate is up to 30 per day, putting them within reach of their 1,000-participant goal. Data analysis is ongoing, but early findings show that many respondents felt they didn’t spend enough time with nurses, according to an official from SEIU Healthcare Pennsylvania, a unit of the Service Employees International Union that represents Magee nurses and is conducting the research.
It’s the kind of feedback that could bolster the union’s main goals: What nursing organizations call “safe staffing ratios” across the hospital’s units and a pay structure that retains experienced nurses. Those changes could have the biggest impact on quality of care and reproductive health outcomes, according to interviews with four Magee registered nurses and two advanced practitioners. They might even lead to the retention of more Black nurses, which could move the needle on widely publicized racial disparities which contributed to Pittsburgh’s placement among the worst American cities for Black women in the Gender Equity Commission report.
“There’s nothing worse than a feeling of going home and knowing that you didn’t do your patients justice because you didn’t have the time,” said Cristina McCarthy, a Neonatal Intensive Care Unit (NICU) nurse who sits on the union’s negotiating committee. And those concerns “have fallen on deaf ears,” she said. “So I think nurses felt that the only option we had was to stand together and really fight for our patients and the time they deserve.”
In response to questions about staffing at Magee, a UPMC spokesperson wrote, “We share our nurses’ goal of providing safe staffing and excellent patient care in every unit and every shift.” But “safe staffing is driven by clinical judgment and unit‑specific needs, not one‑size‑fits‑all ratios.”
‘Itching to voice dissatisfaction’ with UPMC?
The survey has two components: One is for people receiving women’s or birthing care, and the other is for all local nurses and health care workers, who are also grappling with burnout, staffing shortages and other issues that drive many to leave the field. Both ask open-ended questions to prompt rich and detailed feedback.
“So I think this is an exciting way for people — instead of screaming that into the void — to put it into a place where it’s going to be used purposefully for their own benefit.”
Ronni Getz
An SEIU official was “blown away” by the effort people put into their responses. People rarely take the time to answer open-ended questions, but these included “a lot of stories and input,” said Sarah Fishbein, the health care union’s executive vice president.
“I think the community has been itching to voice their dissatisfaction with UPMC for many years,” Ronni Getz, a Magee certified nurse-midwife, told this reporter at a spring training for public transit organizers in Oakland last month. She listed reasons for public discontent with the nonprofit health care giant, including “high health care costs,” fewer choices in a “monopolized” market and “frustration” over the broad tax exemptions it enjoys.
“So I think this is an exciting way for people — instead of screaming that into the void — to put it into a place where it’s going to be used purposefully for their own benefit,” said Getz, who touted the survey during a panel about worker-community solidarity and drew inspired questions from advocates based in other parts of the state.
An expert said the survey is likely a first in the history of collective bargaining: It aims to bring patient feedback straight to corporate officials at the bargaining table, who may never have had to consider community input during labor relations. “They tend to be lawyers” who “don’t have a deep understanding of the experience of patients and members of the community,” said Rebecca Givan, associate professor of labor studies and employment relations at Rutgers University. So “feedback or complaints from patients would likely be completely compartmentalized elsewhere.”
But that’s harder to do when you’re confronted with it at the bargaining table, she added. “The nurses here are potentially doing really smart work in making sure those negotiating the contracts for the employer can’t separate what they’re doing from the lived experience of patients.”
How survey findings could inform bargaining
On Monday the union released two survey findings: 85% of respondents said they need more paid time off from work after leaving the hospital, and many felt they didn’t spend enough time with providers, which limited their ability to ask questions and led to less patient education.
Magee nurses propose safe staffing standards
UPMC Magee-Womens Hosptial nurses and advanced practitioners have proposed the following staffing standards while negotiating their first contract.
Their proposals vary by department and are based on standards set by national professional organizations (in parentheses below). They include the following ratios:
- Labor and Delivery Unit: one nurse to one person who is laboring or receiving synthetic oxytocin (Pitocin) for labor induction (Association of Women’s Health, Obstetric and Neonatal Nurses)
- Neonatal Intensive Care Unit: one nurse to one or two newborns requiring intensive care, and one or more nurses to one unstable newborn requiring complex critical care (AWHONN)
- Postpartum Unit: one nurse to three normal healthy mother-baby couplets and no more than two women recovering from cesarean birth as part of an assignment (AWHONN)
- Lactation Center: 1.3 lactation consultants per 1,000 births and 4.3 lactation consultants per 1,000 NICU babies (United States Lactation Consultant Association).
“Hospitals are really nursing facilities,” said Jean Stone, a maternal and newborn care nurse, and a member of the union’s negotiating committee. “That’s the person who you see the most throughout your stay, and who has an opportunity to really get to know you and your family,” she noted, which equips them to “customize care” and “provide the education and support” a patient needs.
“While we do feel really good about the care that we provide, we feel like it could be even better if we had more time to devote to each patient in any given shift,” she said, adding that’s a near-impossibility without minimum staffing ratios.
This evening nurses plan to speak at Allegheny County Council’s meeting in favor of a resolution in support of a state family and medical leave bill. Some will advocate for the resolution not just for their patients, but for themselves.
Getz, the certified nurse midwife, said Magee’s nurses and advanced practitioners are offered two weeks of paid parental leave — an amount that’s “totally inadequate,” she said. To take more time off, they must “exhaust whatever’s left in your PTO bank” before seeking leave they’re entitled to under the federal Family and Medical Leave Act.
“It’s a terrible system,” she added, noting “the irony” in workers caring for birthing and postpartum people while not having enough parental leave themselves.
Nurses hope this feedback will help wring some concessions out of the officials sitting across from them at the bargaining table, most notably the nurse-to-patient ratios recommended by the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). All six nurses and advanced practitioners interviewed by Public Source said those standards are rarely met across the hospital’s different units.
“It’s shameful that an organization that claims to be a nonprofit — that profited over $600 million last year — doesn’t provide the staff and resources or follow the national guidelines to support these people as they deserve,” said Zelinsky.
UPMC in 2025 reported that revenues exceeded expenses by $643 million.
A UPMC spokesperson wrote in response to questions that “staffing is complex, and fixed ratios don’t address the underlying nursing shortage or the real drivers of workload, such as patient acuity, team structure and real‑time conditions.” The health care system believes, according to the statement provided, that “rigid ratios can create unintended consequences, including reduced flexibility, closed beds and limits on patients’ access to care” and it would rather focus on flexible “team‑based staffing.”
Canvassing to reach underserved patients
In Wilkinsburg, Moore told Zelinsky and emergency nurse Octavia Queen that she’d had mostly good, and at times joyous, experiences at Magee.
“One of my midwives said, ‘You wouldn’t think you were in labor. You were laughing the whole time,’” she recounted. “I was joking around, I got up and we were dancing with the nurses — it was a whole vibe.”
But there were bad moments, too, she said. Zelinsky gently prodded her to describe them.
Moore was in labor with one of her daughters when a nurse entered her room to start an IV drip — without introducing herself or explaining what she was doing. “She just set the needle tray down and started reaching for my arm,” she recounted. “I’m like, ‘OK, what is this? Hi, how are you doing? What’s your name before you touch me?’” The nurse seemed “tired” and may have “worked too many shifts,” she said. “I feel like they didn’t take the time to be like, you know, I’m a person.”
Moore also felt she had no agency while giving birth to her first child as a teen. My care team was “just telling me what to do and not encouraging me to make my own choices,” she said. Holding her son in her arms was her only consolation after the “horrible experience.” I thought, “He’s mine now. I can take him home.”
Moore said she was too young and inexperienced at the time to advocate for herself during birthing care, but added, “I vowed from that day forth I was going to speak up for myself.”
Post-canvassing reflections
After parting ways with Moore on Penn Avenue, Zelinsky said she was saddened by the young mother’s experiences. “To think that we could ever become robotical like that — it’s heartbreaking to me,” she said. “And it creates moral injuries for all of us. You better believe we go home and feel guilty about that, and we carry that trauma with us.”
At 54, Zelinsky’s been a nurse for two decades and was a social worker before that. She “floats to all the areas of OB,” which includes the NICU, the post-anesthesia care unit and high-risk postpartum care. One of her biggest stressors on the job? Caring for patients readmitted to the hospital after being discharged too soon — before they can get crucial education and other supports that can prevent postpartum complications.
Zelinsky said she’s treated “very, very ill patients” who’ve been readmitted with preeclampsia and endometritis — conditions that might have been prevented if patients were monitored for longer periods of time “to prevent readmissions.” She’s on the union’s negotiating committee and said they’ll raise the issue of early discharges as part of their bid for minimum ratios and other safe staffing practices.
Queen, who joined Zelinsky in Wilkinsburg that day, said staffing in the hospital’s emergency department is “really hard to juggle” amid the high volume of patients, ambulances coming in and rapidly changing situations.
Queen, 27, said she is likely one of the only queer, trans Black nurses at Magee. Reflecting on Moore’s experiences, she said, “It’s not easy being Black in Pittsburgh. And it’s not easy advocating and fighting for yourself within the totality of your Blackness and people come in with their guards validly raised when people are stretched thin.”
Venuri Siriwardane is the health and mental health reporter at Pittsburgh’s Public Source. She can be reached at venuri@publicsource.org or on Bluesky @venuri.bsky.social.
The Jewish Healthcare Foundation has contributed funding to Public Source’s health care reporting.
This story was fact-checked by Rich Lord.
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