Meanwhile, inside the hospital, other nurses and staff members were eating pizza as part of an "employee appreciation day" celebration.

The issue is critical, Gay said, because of a worsening nursing shortage and the conditions in which they're being asked to work, including the number of patients each must care for at one time.

"This would allow us to meet with management and have a say in our schedules, our pay, how many patients we care for. To improve working conditions."

Harleman said that about 18 percent of nurses in the United States belong to unions, compared to 13 percent of the general working population. But the trend in nursing is on the upswing, spurred by nursing shortages and the working conditions they create.

And both sides noted that the issue has dragged on long enough that many of the nurses who cast ballots are no longer working at the hospital, although the ballot results would stand, even if no one who voted remained.

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E-mail: lois@desnews.com