NAPA --Registered nurses at Queen of the Valley Medical Center voted by a 64 percent margin on Tuesday to affiliate with the California Nurses Association, an affiliate of National Nurses United, both the union and officials at the St. Joseph Health-owned hospital said.

The nurses voted 248 to 140 in favor of joining CNA, a powerful union headquartered in Oakland, in a secret ballot election held by the National Labor Relations Board, according to the union.

The NLRB must certify the election results before CNA can represent a total of 443 nurses there, according to hospital officials.

Union officials said nurses had expressed growing concern about appropriate staffing levels for both RNs and other hospital staff, which became a key factor in nurses' decision to vote overwhelmingly in favor of CNA representation. Additionally, the union said hospital unit closures and economic cuts were also factors.

“Now that the nurses at Queen of the Valley have spoken clearly by choosing our union, the California Nurses Association, we can advocate strongly for our patients to have the best care possible, and for the future of nursing,” said Karen McNair, RN, of Queen of the Valley, in a statement. Nurses at Queen of the Valley also cited the influence of CNA's national affiliate, National Nurses United, which represents over 185,000 RNs nationwide.

Hospital officials said that while they await certification, the administration would respect the decision by the nurses to unionize.

"The Queen remains focused on respecting the decision the majority of our registered nurses who voted have made about union representation,” said Walt Mickens, president and chief executive officer in a statement. “It’s time to heal and move forward together. I have no doubt we will do so because here at the Queen, we already have the gift of unity: we are united in a shared desire to further our mission of improving the health and quality of life of the people of Napa. Nothing will change this.”

The union said it has been growing its influence within the Orange-based St. Joseph Health system, which also owns Santa Rosa Memorial and operates Petaluma Valley Hospital.

Overall, CNA said it now represents about 1,600 St. Joseph RNs at St. Joseph Hospital in Eureka, Petaluma Valley Hospital and St. Mary Medical Center in Apple Valley in Southern California and now Queen of the Valley.Memorial, the region's busiest trauma center, does not have CNA representation and its nurses are part of the local Staff Nurses Association. 

In a statement, Suki Stanton, vice president of patient care services and chief nursing officer, said the hospital is "proud of how all of our registered nurses and staff have remained committed to our patients throughout this process," and added "We will continue to respect one another’s views."

No other unions represent employees at Queen of the Valley, according to the hospital.

Elsewhere in hospital-labor negations, the NLRB is expected to begin counting votes today in the hotly contested, intraunion battle taking place at Kaiser Permanente facilities throughout Northern California. The National Union of Healthcare Workers is attempting to unseat Service Employees International Union--United Healthcare Workers West for representation of about 45,000 employees, including roughly 4,700 across facilities in Marin, Sonoma, Napa and Solano counties.

NUHW is aligned with the nurses union.