In a bold step at Santa Barbara County’s largest medical provider, Cottage Health nurses announced a unionization campaign Friday, citing the region’s high cost of living while describing a growing dissatisfaction with their working conditions.
Flanked by family members and three Santa Barbara City Council members, nurses at the forefront of the effort gathered across the street from the healthcare system’s flagship Santa Barbara Cottage Hospital—and said they hope to hold and win a union election before the end of the year.
“Our patients have a great experience because of the care that we provide to them every day,” said Dianna Hosley, an oncology nurse and former coordinator of the Santa Barbara County Sexual Assault Response Team (SART).
“That excellent care often comes at a cost,” Hosley said. “We need more staff. We need better compensation. We need some basic transparency, and we’ve tried everything we can, but our efforts have fallen on deaf ears.”
Organizing with SEIU 121RN, more than 30% of Cottage Health nurses have signed union authorization cards —enough to trigger an election overseen by the National Labor Relations Board, said Monique Hernandez, vice president of the union.
Prior to the nurses’ announcement, Cottage Health leaders told the News-Press they respect employees’ right to choose, but also don’t believe third-party representation is the best choice.
“Our position is that we don’t believe we need a union or a third party to be the intermediary,” said Cara Williams, Cottage vice president of human resources and chief human resources officer. “We enjoy a direct connection to our employees, and we want to maintain that.
“Having a union is not going to change how much it costs to live in Santa Barbara and the cost of housing,” Williams said.
‘We deserve better’
As they seek collective bargaining representation, the nurses noted Cottage reported $252 million in profits in 2025.
“Cottage has the money to properly compensate us,” said nurse Tatiana Speier, who works at the Santa Barbara Cottage Hospital emergency room.
Cottage recently changed how employees access sick leave without providing notice, Speier said, adding this led to a freeze in vacation approvals made months in advance.
“These were so-called guaranteed benefits,” Speier said. “And from this we’ve realized Cottage has the ability to take away any benefit without our say… We deserve better, and it’s time for a change.”
An existing shared governance system at Cottage is valuable, enabling nurses to surface concerns about workflows and equipment shortages, Speier said.
However, that system falls short of providing nurses a voice on wages, benefits and staffing ratios, she said. “We’re hoping that a union can bridge that gap.”
A changing healthcare landscape
The union push comes as Cottage expands with an increased focus on addressing maternal health, children’s health and chronic conditions through strategies that include more outpatient services. The organization, for example, has plans for a $35 to $45 million Cottage Health hub in Buellton to fill Santa Ynez Valley coverage gaps.
That plan comes three years after the Sacramento-based nonprofit Sutter Health, a chain of two dozen hospitals and 200 clinics, expanded south to Santa Barbara County by acquiring Sansum Medical Clinic, an institution dating to 1921.
And it comes two years after UCLA Health opened a South Coast flagship facility on Victoria Street in Santa Barbara, growing its primary and specialty care footprint while incorporating a cancer care clinic. The organization also has a primary and specialty care center in Montecito.
Cottage administrators acknowledge the healthcare system is profitable, emphasizing 52% of the organization’s 2025 profits went to wages and benefits.
Because Cottage is a nonprofit, they note, all revenue over expenditures is re-invested into the organization and community. Among other initiatives, Cottage plans to spend more than $200 million to build workforce housing and $11 million to expand a child care center.
Raises, mandates and time off
Cottage is a healthy workplace and a desirable place to work, administrators said Friday, citing statistics on pay increases, hiring and employee retention.
On average, Cottage clinical nurses earn $68.62 an hour. They received 6.3% pay increases this year and in 2025, preceded by 5.4% in 2024, 6.3% in 2023 and 6% in 2022, system officials say.
In addition, they said the organization is in compliance with nurse-to-patient ratios mandated by the state of California.
Issues with time-off approvals have been addressed and more improvements are coming, Williams said, describing a change in the organization’s timekeeping system that created problems for employees accessing accrued leave.
“There have not been any cuts,” she said, stating no employees lost benefits eligibility.
In addition, Cottage officials point to a range of what they described Friday as benefit enhancements made in the past three years. These include fertility assistance, accident insurance, menopause education, nutrition counseling, diabetes prevention and mortgage and home-purchase down payment assistance.
The organization, onboards 100 nurses annually, and a cohort of recent graduates the hospital welcomed on Oct. 19 included 28 new hires out of 897 applicants, administrators say.
‘The heartbeat of the organization’
Only 8.2% of nurses at Cottage left the hospital in the latest annual tally, compared to a Hospital Association of Southern California benchmark of 12%, Cottage officials say.
“Professional nursing is challenging,” said Laura Canfield, Cottage vice president for patient care services and chief nursing officer. “Nurses are highly valued at Cottage Health. They are the heartbeat of the organization.
“Their voices are incredibly important to us,” said Canfield, who’s spent half of her 30-year career in nursing at Cottage. “We have a decades-long demonstration of working together to improve how we care for this community, and we are committed to continuing to do that.”
The healthcare system’s opposition to the unionization campaign will be respectful, she said.
“My job and obligation is to make sure that nursing has information that is helpful,” Canfield said, adding that some nurses do not believe unionization is the appropriate path while others have expressed concerns about union dues or the possibility that existing benefits could be affected.
“We are obligated to inform and share, and we are very aware of the boundaries,” Canfield said.
‘Pretty shocking’
At Friday’s announcement, the nurses said their average pay falls below statewide averages—making it difficult to rent homes along the South Coast, which leads to longer and more exhausting commutes, they said.
In addition, they described a lack of wage transparency.
The oncology nurse Hosley said she and her colleagues recently began comparing their hourly wages, and that what they found didn’t make sense.
“What we found was pretty shocking,” she said. “There doesn’t seem to be any rhyme or reason to what people make. Nurses who put in the extra work to obtain advanced degrees or specialty certifications are not compensated with an increase… None of this helps attract or retain the type of nurses that our patients deserve.”
Emergency room nurse Clare Upton said the union isn’t a third party.
“I’m here today to tell you that the Cottage nurses are the union,” Upton said. “It was the nurses who reached out and contacted SEIU. And it will be the nurses who sit across the table and bargain with management once we win.”
Political support
Santa Barbara City Council members Oscar Gutierrez and Wendy Santamaria, a former labor organizer, and Kristen Sneddon, a candidate for mayor, joined the nurses Friday.
“At some point in everyone’s life, a nurse is the most important person in your life,” Sneddon said, adding nurses bring unique physical and emotional strengths to the job. “Look at the shoes that nurses wear. Those are twelve-hour shifts and more.”
Santamaria said wealthy Santa Barbara residents depend on Cottage nurses.
“And while somebody else makes that extra dollar, or extra millions of dollars, it’s the nurses that have to be left with commuting long hours, packing in tighter, facing rent increases after rent increases that the wages just don’t keep up with,” she said. “We are watching what Cottage Hospital is doing.”
