A few years ago, my co-workers and I began talking quietly about forming a union at Yale-New Haven Hospital. Today we are close to turning those first tentative discussions into reality by joining the New England Health Care Employees Union District 1199, which is affiliated with the Federation of Hospital and University Employees at Yale.

We are nursing assistants, clerical workers, housekeeping and maintenance workers, operating room technical associates, patient registrars, and phlebotomists, just to name a few. Although we do different work, we share common goals in forming our union.

A union contract is a set of negotiated rules that prevent favoritism. Currently, there is no equity in how different employees are treated. Workloads, evaluations or flexibility can change overnight based on arbitrary criteria, or no criteria at all.

“Restructuring” in the health care industry has resulted in profound changes in our work. Over the last decade, Yale-New Haven has shifted much of the responsibility for hands-on patient care from licensed nurses to unlicensed (and lower-paid) “patient care associates.” By forming a union, we are guaranteed input into such restructuring, ensuring that changes are made with the cooperation of the front-line personnel most affected.

Yale’s teaching hospital remains one of the world’s top medical institutions. Yet current patients often compare their recent experiences unfavorably with previous hospitalizations. Problems include longer waits, less attention and too few staff. Studies by the Institute of Medicine show a direct correlation between staffing levels and the quality of patient care.

Joining the union would give us a voice as the hospital adjusts resources. We’re all concerned about the cuts and changes that affect the patients we serve. The nursing staff is stretched thin and can’t always deliver the swift, attentive care patients need. At unionized hospitals around the nation, joint labor-management committees work together to establish and maintain safe and effective staffing levels.

Our work force is overwhelmingly female. For single parents, arbitrary changes in schedules wreak havoc with childcare and transportation arrangements. A union is the only effective way we can participate in decisions about scheduling and limit the overuse of mandatory overtime.

This year, Yale-New Haven was again named one of the country’s “Top Hospitals.”

We’re on the cutting edge when it comes to investing in the most advanced equipment and, at $985,395 annually, President and CEO Joe Zaccagnino is the best-compensated hospital executive in Connecticut.

But when it comes to investing in hospital staff, Yale-New Haven doesn’t rank quite so high. The starting hourly wage for housekeeping personnel is less than $9.00 an hour. Patient care associates start at $10.85. The Connecticut Office of Policy and Management has calculated the “self-sufficiency wage” –Êthe income level necessary to cover the basics of rent, food, health care, etc. — for a New Haven single parent with two children to be $18.24 in 2001. Many of my co-workers must hold two or three jobs, not to “get ahead,” but simply to make ends meet.

We don’t have to turn to national labor statistics to understand the economics of the “union difference.” At Waterbury Hospital, an institution with far fewer resources than Yale, patient care associates start at $13.55 hourly under the union contract, about 25 percent more than patient care associates at Yale. The starting wage at Waterbury is higher than the average wage for Yale workers, no matter their length of service.

I am a registrar in patient finance admitting services at the hospital. After 20 years, I earn just over $15.00 an hour. At a similar job at Yale in Local 34, I would earn at least $19.35. With no structured salary system or recognition for seniority, longtime workers like myself suffer from pay inequities, finding ourselves training less experienced employees earning more than we do.

Of course, joining a union doesn’t automatically result in higher wages, fewer inequities, lower premiums or better benefits. What it does guarantee is that we will have the means to negotiate about these issues, the right to information about proposed changes, and real, effective, not-to-be-ignored input into the decisions that affect us.

While the University celebrated its tercentennial this year, Yale-New Haven Hospital marked its 175th anniversary. The hospital is running a series of newspaper ads, called “Voices,” featuring stories from patients, families and staff. The union drive among hospital workers is an effort to find and develop our own collective voice in the workplace. We are asking our hospital to recognize and acknowledge that voice. We are asking to be heard.

Lynn Eimutis is a registrar in patient finance admitting services at Yale-New Haven Hospital.