LEBANON — With a unionization campaign by Dartmouth Hitchcock Medical Center nurses making more headway than two previous attempts, the hospital’s administration has hired a prominent California anti-union consultant to resist organizing efforts.

Union organizers have collected signatures from 30% of DHMC’s roughly 2,500 nurses, Nela Hadzic, regional organizing director for the Northeast Nurses Association, said in an email this week.

The National Labor Relations Board’s threshold to hold an election is 30% of a workforce, but DHMC nurses plan to continue to collect signatures before seeking a vote. To bring Dartmouth Health, DHMC’s parent organization, to the bargaining table, a simple majority of nurses must vote in favor of unionization.

“This is much further along than they’ve gotten before” in the process, said Hadzic, who assist health care workers in trying to form unions.

The DHMC union drive began in mid-March, and since then nurses have been distributing fliers, hosting informational events, and using social media to encourage their colleagues to sign union cards.

In April, Dartmouth Health hired Crossroads Group Labor Relations Consultants, of San Clemente, Calif., at a rate of $450 per hour plus expenses, according to a mandatory disclosure report filed by both parties in early April with the U.S. Department of Labor.

Crossroads is distributing written materials and making presentations to DHMC nurses to “persuade employees to exercise or not to exercise … the right to organize and bargain collectively through representatives of their choosing,” stated the federal disclosure report.

Dartmouth Health declined to say how much it has paid Crossroads so far, but “we are glad to have found contractors with expertise to help educate our employees and provide them with accurate information about union representation,” Chief Nursing Officer Tracy Galvin said in a statement Thursday.

Companies like Crossroads are commonly known as anti-union consultants, and their purpose is to prevent an election from occurring in the first place, and if it does, to ensure that unionization fails at the ballot box, Hadzic said.

DHMC nurses estimate about 12 anti-union consultants working in the hospital, based on the different people they have observed holding meetings with nurses, Hadzic added.

“They are union-busters” and hiring them is part of a standard playbook of tactics used by employers who oppose unionization, Vermont Law and Graduate School Professor Joan Vogel, who specializes in employment law, said in a telephone interview.

“This is about power,” she added.

Employees trying to unionize typically want “living wages, decent working hours, and control over their schedules,” Vogel said. “What they are asking for is not unreasonable, and employers can get in trouble when they push back against that.”

The nurses’ chief complaints are the lack of a fair and transparent wage scale, nurse-to-patient ratios that they say compromise patient safety, and an administration that has been unresponsive to their concerns.

“A union will give us leverage and a voice,” Alicia Patten, a DHMC vascular access nurse, said in a telephone interview.

Patten, 47, lives in Hartford and has worked at DHMC for 11 years. Her work takes her to care units throughout the 507-bed hospital, where she sees nurses “struggling without enough help and adequate resources to care for patients,” she said. Patten has seen nurses without enough support staff to help move patients, and nurses who are responsible for five or more patients at a time.

DHMC nurses previously took steps to unionize in 2008 and 2010. Both attempts failed to reach the election stage.

“Every time they tried, management made them afraid they would lose something, like their pensions, low-deductible health insurance or flexibility in their schedules. They fell for it, and then those things were taken away anyway,” Hadzic said.

Meanwhile, hospital leaders argue that a union would hamper “open dialogue” between management and employees.

DHMC’s administrators maintain a union is “not necessary and could be counter-productive to the kind of two-way dialogue that is so deeply rooted as a part of our culture,” Galvin said in her statement issued Thursday.

It is not lost on DHMC nurses that the medical center is committing significant sums to combat unionization.

“All this money they are spending on these union-busters,” Patten said, “that could be money spent on patient care.”

It’s not just hospital executives who oppose the union. Some nurses have pushed back against union organizers, arguing that collective bargaining is unnecessary.

“I don’t really see how we’ll benefit from a pay standpoint,” said Lisa Davenport, a nurse educator and a salaried employee whose work supports the heart and vascular unit.

In early April, Davenport helped establish an organization called DHMC Works for Me, which includes nurses who want a union-free workplace. The group established a GoFundMe campaign that raised more than $600 and garnered 12 signatures.

Davenport also expressed concerns about unions protecting poor-performing nurses, creating an additional layer of bureaucracy and stifling flexibility.

“A lot of us who are against the union believe strongly that unions reward mediocrity, they don’t reward nursing excellence,” she said. “We feel like we don’t need a middleman coming between us and the nursing leadership,” she said.

Pro-union nurses disagree that unionization will encourage or foster lackluster performance.

“Talented and experienced nurses are coming together to form a union because we want to provide excellent patient care, and unfortunately, upper management hasn’t provided us with the tools we need to do that,” Greg Moore, who has worked as a nurse at DHMC for 23 years, said in an email.

“We’re looking forward to winning a seat at the table so that we can retain talented nurses, raise standards across the hospital, and make the improvements that our co-workers and patients deserve,” Moore added.

Davenport is “pretty optimistic” that a shared governance model championed by Galvin will be effective.

Meanwhile, Patten, the vascular nurse, rejected promises of shared governance as just “more of the same.”

“There isn’t a contract with shared governance. We’ve voiced our concerns in the past but we feel unheard,” she said. “We’re interested in holding our employer accountable to do what they say they will do.”

The Dartmouth Nurses Alliance wants to form a New Hampshire branch of the Massachusetts Nurses Association, a federation of unions at more than 80 healthcare facilities in Massachusetts, including Brigham and Women’s Hospital and the Dana Farber Cancer Institute in Boston.

Healthcare workers nationwide have become increasingly interested in unionizing in recent years, Hadzic said. Already short-staffed before the arrival of COVID-19, “the pandemic really pushed a lot of health care workers over the edge,” and many left the profession, she added.

And while only about 10% of American workers belong to a union, “there’s a much more favorable opinion of unions these days,” said Vogel, the employment law professor. Workers are deciding that they “don’t want to depend on the goodwill of people who don’t always have goodwill,” she added.

Despite the efforts to oppose the union, should a union vote succeed, Galvin said, “DHMC would negotiate in good faith with a certified union.”

Christina Dolan can be reached at cdolan@vnews.com or 603-727-3208.