Registered nurses at SSM Health Saint Louis University Hospital in St. Louis, Missouri rallied outside the facility on Wednesday, July 22, demanding the immediate reinstatement of two nurses — Jessica Tulk and Earline Shepard — who were terminated for participating in protected, concerted union activities. The rally was organized by National Nurses United (NNU), which represents nurses at the hospital and called the terminations unlawful retaliation under the National Labor Relations Act (NLRA).
NNU characterized both nurses as "highly skilled and dedicated," and said their dismissals followed their involvement in union organizing activities that are explicitly protected under federal labor law. The NLRA prohibits employers from disciplining or terminating employees for engaging in collective action, union organizing, or other concerted activities related to working conditions. Filing an unfair labor practice (ULP) charge with the National Labor Relations Board is the standard legal avenue in such disputes; as of publication, the union has not publicly confirmed whether a formal NLRB charge has been filed in connection with these specific terminations.
Context: A Hospital With a Documented History of Labor Disputes
The July 22 rally did not happen in isolation. SSM Health Saint Louis University Hospital has a well-documented labor relations history that spans the better part of three years. In July 2024, nurses at the facility ratified a three-year contract that included safe-staffing provisions, ending more than a year of contentious bargaining that had included two strikes. The contract was widely described at the time as a resolution to the fundamental staffing dispute at the hospital.
But ratifying a contract and implementing it are different things. Multiple reports since the 2024 ratification indicate that persistent nursing vacancies at SLUH have continued, with heavy reliance on temporary agency nurses to cover unit staffing — the exact dynamic the staffing provisions were intended to address. Agency nurses operating outside the collective bargaining agreement's terms can functionally undercut the staffing protections a CBA establishes, which is a friction point in union contracts across the country when vacancy rates stay elevated long after a deal is signed.
The nurse terminations fit a pattern that labor advocates describe as "chilling activity" — taking a visible adverse action against specific union-active employees to discourage broader participation. Whether that characterization holds up legally depends on what specific activities the nurses were engaged in and how SSM Health characterizes its basis for termination. The company had not issued a public statement as of publication.
What NLRA Protection Actually Covers — and What It Doesn't
The National Labor Relations Act's Section 7 protects "concerted activities for the purpose of collective bargaining or other mutual aid or protection." This is broader than most nurses realize. Protected concerted activity includes:
- Discussing wages, working conditions, or staffing concerns with colleagues
- Organizing or encouraging colleagues to join a union
- Filing or assisting in filing a grievance under a collective bargaining agreement
- Participating in authorized union activities including picketing and rallies
- Refusing to cross a lawful picket line
- Raising staffing or safety concerns collectively with coworkers (distinct from individual complaints)
Protection under Section 7 applies even to non-union nurses at non-union facilities — the NLRA does not require a union to be present for concerted activity protections to apply. What matters is whether the activity was genuinely "concerted" (involving two or more employees or a single employee acting on behalf of co-workers) and related to working conditions. This is relevant context for nurses anywhere who participate in any form of collective advocacy for staffing or working conditions.
What Section 7 does not protect: individual complaints that do not implicate collective working conditions, conduct that is sufficiently egregious to lose protected status (e.g., threats or serious misconduct), or activities that violate a valid no-solicitation or no-distribution policy applied consistently to all employees. Employers routinely assert these defenses when terminating union-active employees; the NLRB adjudicates whether the specific circumstances qualify.
The Broader Pattern in 2026
The SLUH terminations arrive in a labor climate that has seen elevated unfair labor practice charges in healthcare. The number of ULP charges filed against healthcare employers has increased year-over-year since 2020, and post-pandemic contract expirations at large systems in 2024 and 2025 have produced a fresh round of union organizing campaigns at facilities that did not previously have collective bargaining agreements. Several of those campaigns have generated adverse-action allegations.
For nurses in union and non-union settings alike, the SLUH situation is a reminder that NLRA protections exist and are enforceable — but only if nurses know them and document the activities at issue before a termination occurs. If you engage in any form of collective advocacy at work, keep records: dates, who else was involved, what was discussed. If an adverse action follows, that documentation becomes the factual record for an NLRB charge.