Nursing is more than a job to Tatiana Speier. Born and raised in Santa Barbara, she joined Cottage Hospital’s oncology department in 2021, inspired by the nurses who cared for her late uncle. She has since transferred to the emergency department, where she encounters everything from traumatic injuries to families saying their final goodbyes.
It’s difficult, emotionally exhausting work. Still, Speier wouldn’t trade it for anything. “We love what we do and we love our patients,” she said of the 1,300 registered nurses across Cottage Health’s campuses. “But because we’re caregivers, we have a hard time taking care of ourselves. We forget to prioritize ourselves.”
Now, Speier and a growing contingent of Cottage nurses are trying to do exactly that. They’re pushing to unionize, hoping to win better wages, stronger benefits, safer staffing, and something they say has been sorely missing from their workplace: a meaningful voice in how the organization operates. They also point to Santa Barbara’s extraordinary cost of living, which has forced many of them to move farther away from the communities they serve.
This Friday, nurses from Santa Barbara and Goleta Valley Cottage hospitals will gather with their families to publicly announce their campaign to join Service Employees International Union (SEIU) Local 121RN, which represents healthcare professionals throughout Southern California. The nurses have been quietly collecting authorization cards from their colleagues and, if they get 30 percent of the staff’s support, will petition the National Labor Relations Board to hold a secret-ballot election, where a majority vote is needed to join the union. A previous effort in 2000 fell just short.
“We need a voice,” said Reyna Estrada Rioux, who works night shifts and described a co-worker who recently fell asleep behind the wheel and crashed. The accident took place after Cottage abruptly eliminated an employee shuttle serving Ventura-area commuters. “People are burnt out,” Rioux said. “We’re at our wit’s end.”
The nurses interviewed by the Independent emphasized that their frustration with hospital management shouldn’t be mistaken for dissatisfaction with Cottage as a whole. All of them said they take enormous pride in the institution’s contributions to the community. Rather, they argue that the people responsible for delivering care should have more influence over the conditions under which that care is provided.
For its part, Cottage Health maintains that nurses would be best served by taking their concerns directly to hospital leadership rather than involving a union. In a statement to the Independent, Laura Canfield, Cottage’s vice president of patient care services and chief nursing officer, defended the hospital’s record as an employer, pointing to its Great Place to Work certification and recognition as a top company for working parents.
Canfield characterized the union campaign as an unwanted outside influence, accusing an “external organization” of attempting to “compromise the 135 years of proven excellence, integrity, and compassion” that Santa Barbara has come to rely on.
Canfield also defended Cottage’s 25-year-old shared-governance model, which she said allows the hospital to gather staff feedback and develop solutions. “We remain committed to finding new ways to support our teams and continue to feel that our employees are best served by expressing their concerns with leadership directly and not involving a third party,” she said.
But that’s precisely where the nurses say the system has fallen short. They argue the hospital’s existing channels for addressing problems have proven ineffective. Among their specific grievances are recent, unannounced changes to Cottage’s long-term sick-leave policy; chronic understaffing; inadequate pay differentials for working nights, weekends, and in specialized departments; an opaque raise structure and schedule; and $100 annual bonuses, which Speier called “embarrassing.”
For Clare Upton, an emergency room nurse at Goleta Valley Cottage Hospital, those frustrations, among others, helped spark the union campaign nearly two years ago. A fourth-generation Santa Barbaran who earned her nursing degree at Santa Barbara City College and has six years of experience under her belt, Upton previously served on Cottage’s shared-governance committee.
Soon after joining, however, Upton discovered that most meaningful subjects were largely off-limits. Members could help select Nurses Week prizes, she said, but couldn’t negotiate raises or establish lasting workplace protections. After repeatedly banging her head against the wall, she began exploring union representation with two other colleagues.
Upton disputes Cottage’s characterization of unions as outside organizations interfering with local hospital operations. “We would be the union,” she said, explaining how SEIU would provide legal representation and financial advisors during contract negotiations, but not meddle in the day-to-day, on-the-ground duties of staff. “And the people who are going to be advocating for us? That’s me,” said Upton. “That’s my coworkers. That’s us.”
In a press statement, SEIU argued that Cottage has the financial resources to improve nurses’ pay and working conditions. The union cited financial reports showing Cottage Health cleared approximately $252 million in revenue last year. Those reports also show its top 14 executives earned a cumulative $13.1 million in salaries, with the CEO taking home just over $2 million.
Meanwhile, Cottage leadership has been steadily trying to discourage unionization through emails, staff meetings, and an internal website warning of the potential downsides, the nurses said. Administrators have portrayed unions as outsiders only interested in collecting dues, and they’ve stoked fears that collective bargaining could threaten existing benefits, including employee housing and tuition assistance. Some nurses also worry about retaliation for supporting the campaign.
Organizers acknowledged that Cottage faces financial challenges in the coming years as federal healthcare funding cuts enacted under President Donald Trump’s One Big Beautiful Bill Act begin taking effect. The legislation, signed into law in July 2025, is expected to reduce federal Medicaid spending by hundreds of billions of dollars over the next decade, putting major pressure on hospitals throughout California.
Speier argued the looming uncertainty makes union representation all the more important, allowing nurses to negotiate contractual protections against future reductions. With a union, she said, nurses could fight to maintain proper staffing levels and preserve the pay and benefits they currently receive, rather than having those decisions made unilaterally down the road by hospital administrators.
The organizing effort at Cottage comes amid a series of successful unionization campaigns at hospitals across the country. In January, nearly 500 nurses at Community Hospital of the Monterey Peninsula voted to join the California Nurses Association. In May, nurses at Chicago’s Rush University Medical Center voted 77 percent in favor of union representation, followed in June by an 89 percent majority at St. Mary’s Hospital in Madison, Wisconsin.
Finally, in July, nearly 10,000 attending physicians throughout the University of California system launched a unionization campaign, citing burnout, inadequate compensation, and a lack of influence over decisions affecting patient care. These collective actions prove “that healthcare professionals at the bedside – not just executives in the board room – must have a voice in their jobs and how they deliver care,” SEIU said in its statement.
For Speier and others, the push to unionize is about more than wages and benefits. It’s about being able to build a life in the community they serve. New data from the Economic Research Institute lists Santa Barbara as the 30th most expensive place to live out of America’s 6,011 cities. The cost of living in Santa Barbara is 78% above the U.S. average and 27% above the California average.
“My dream is to buy a home and raise a family here, like my parents did for me,” Speier said. She sees unionization as a natural extension of the solidarity that exists among nurses, and she’s thinking about the next generation, including a younger cousin who hopes to enter the profession. “I don’t think Cottage’s treatment of us reflects how important we are,” she said. “We deserve better.”
“Nurses are the backbone of Cottage,” Upton agreed. “When was the last time a Cottage executive held someone’s hand while they were dying? When was the last time they sat with grieving family members and helped them understand how hard we worked for their loved one? When was the last time they showed up and worked a 12-hour shift?”
“We’ve finally realized that Cottage executives aren’t going to be the advocates we need,” she said, “and that we need to advocate for ourselves and make sure our priorities – our patients, our families and our community – come first.”
