In a week that brought focus to hazy questions of who can form unions, what issues unions should address, and the role of labor at Yale, the organizing drive of 1,800 Yale-New Haven Hospital workers stands alone as a straightforward issue of workers’ right to unionize. Like their peers at Yale, the custodians and service workers at the hospital perform work that has long been considered eligible for unionization under law. They have the right to decide whether to form a union and should do so through a National Labor Relations Board election.

Union leaders have called on Yale President Richard Levin to use his position on the hospital board to urge hospital CEO Joseph Zaccagnino to allow a union. While Levin’s support might help the union cause, he is under no obligation to support the union. More importantly, Levin’s support would remain meaningless in the face of a hospital administration staunchly opposed to unionization. Given the professed anti-union views of the administration, nothing short of a legal election would allow workers to form a union.

Union leaders have recently hedged recommendations to hold an NLRB election, citing intimidation by hospital officials and inadequacies in labor law enforcement to protect workers from intimidation. While reports of intimidation at the hospital are troubling and the NLRB frequently implicitly favors employers in its policy enforcement, an election remains the only realistic option for workers.

The underlying paradox of any alternative means of achieving recognition is that it relies on consent from the employer. Given that union leaders have sought to bypass the NLRB because they believe the hospital will employ unfair means to prevent a union, it seems illogical to expect the hospital to respect any other extralegal method that would make unionization more likely. The NLRB process may be flawed, but it remains one of the only realistic and effective options for workers to determine whether they wish to be represented by a union.

Hospitals have traditionally been difficult types of businesses to unionize, in part because the impact of a strike seems more drastic and because hospital workers tend to work in very spread out, separate departments and do not have much contact with one another. Apart from the type of employer, there is little unique about the hospital workers that should make their quest for unionization as complex as it has been. Indeed, it seems more reasonable to wonder why the workers have not yet held an election.

The organizing drive has proven a major stopping point for negotiations between the hospital and its existing union, which have been trying to reach a settlement for more than two years. The hospital union negotiations provide leverage for the organizing drive, which in turn gains clout through its link to the existing union. The relationship may be complicated, but the course of action for hospital workers is simple: they deserve a union and they should vote.