LATROBE, Pa. — The votes are in, and Lisa Kyper is wondering whether the doughnuts did the trick.

The labor organizer had been working 55-hour weeks and popping antacids from a jumbo bottle while wooing some 300 registered nurses at Latrobe Area Hospital.

One day last month, she used Dunkin' Donuts to try to sway potential recruits. Now she and others from the Pennsylvania State Education Association — the largest union in a union-friendly state — will learn how five months of toil ends.

"I think we've got a good shot," Kyper said. "Nurses are analytical and like to hear all sides of an argument before they make a decision, and I think we've made a good case."

Kyper and Alf Nelson, a 35-year PSEA veteran who shows the Oscar-winning labor film "Norma Rae" in classes on organizing, guess there are 100 undecided votes among the RNs — a big variable when 159 votes could win for either side.

Not only must they insinuate themselves into long-standing relationships between employer and employee, organizers also must buck trends that show unions are increasingly less popular. Kyper came into Latrobe having lost all three of her previous campaigns.

Union membership in the United States fell from 13.9 percent in 1999 to 13.5 percent last year, according to a report by the U.S. Bureau of Labor Statistics. In the mid-1950s, during labor's heyday, about 35 percent of workers carried union cards, said Adrienne Eaton, a labor studies professor at Rutgers University.

The historic argument has been that a union can get workers a better deal, but now that's sometimes a hard sell.

It became clear early on that the union was going to lose big. The final count was 164-109.

Nationwide, non-managerial professionals who didn't belong to unions on average got 4.7 percent raises last year, while union members in the same category received only 1.8 percent hikes, according to the federal labor report. The two groups earned nearly equal money — $841 a week for union, $832 for non-union.

"The problem today is not convincing people that their boss is bad for them," said Marick Masters, a business professor at the Katz Graduate School of Business at the University of Pittsburgh. "The problem is convincing them that there is a good reason for them to join a union."

Thus, the doughnuts.

Kyper, a former nurse, and union nurses from other hospitals walked into Latrobe Area Hospital's emergency room before dawn one February morning with 30 dozen piled on a stretcher.

"You have to be creative in this job," Kyper said. "Management has got a captive audience — they can call a mandatory meeting to state their case, and they do."

Executives reacted swiftly once news broke last fall about the PSEA's campaign at the 90-year-old hospital, which has never been unionized. Nurses met in small groups with Doug Clark, the hospital's chief executive.

Nurses said he wept and pleaded for more time to respond to nurses' concerns about heavy workloads and forced overtime, although Clark says the meetings were less emotional.

"One of the things we talked about was whether the nurses wanted to work with us through a third party or with management directly," he said. "There are some things we still need to do here. We talked to a lot of nurses during the campaign, and we plan to keep doing that."

At Frick Hospital in nearby Mount Pleasant, Kyper lost an election earlier this year that she figured she would win by 50 votes. She learned later that management sweetened benefits for RNs just before the vote.

"They were fickle," she said. "They were the kind of nurses who scream 'union' to management to get what they want, and then you never hear from them again."

Masters, the business professor at Pitt, said workers for years have realized that they can play management off unions.

"It is a relatively low-cost tactic on the part of employees to indicate, truthfully or not, that they have been approached by a union, and that management might be interested in stopping this," he said.

The scrappy Kyper said her nursing background helps her relate to potential recruits. She took calls from them as late as 1 a.m. and learned not only the names of all 317 Latrobe nurses, but also their shifts and job descriptions.

"There is a huge barrier between employees and their management, and my job is to take that down," she said. "And I've been there. I have done what they do, and I've been in management, too."

But the nature of nursing works against her. The relationship between a hospital and its nurses is like that of father and adoring daughters, Kyper says.

Beth Bergman-Davis, a Latrobe emergency room nurse, says she had no need for union representation until two years ago, when the workload prompted her to consider quitting.

"I am a single parent with two kids. I work, and I go home. That's what I do. I've never done anything like this in my life," she said. "But I've had it. We are professionals, and we should be dealt with professionally."

The hospital, she says, transfers patients to other units too slowly, creating more work in the emergency room. The hospital says it is working on the problem.

On the night of the vote in late February, Kyper, Nelson and others lined up along the left side of a packed and tense hospital classroom. Jokes were made about "hanging chads," though no one said much else above a low whisper. The National Labor Relations Board's election supervisor warned the audience about noise.

It became clear early on that the union was going to lose big. The final count was 164-109, with some nurses not abstaining and some ballots ruled invalid. The reaction was subdued, with nurses saving their hugs and tears for the hallway afterward.

Kyper, now 0-for-4, gathered some of the nurses at a nearby restaurant for a consolation party and remained chipper in defeat. To soften the blow, Nelson recalled how he needed five tries over 10 years to organize teachers at a private school in central Pennsylvania.

"The ball's in their court now," he said of hospital management. "They're on notice that things have to get better."

Over a double vodka, Kyper vowed to be back — but not until after she returns from her first vacation in two years.

"I don't want my calm demeanor to indicate I don't care," Kyper said. "Look at the big picture. We only need 28 more votes. We'll go another round before we give up."

The PSEA must wait a year under federal law before asking for another vote in Latrobe. Kyper said she'll be working the phones long before then. Nelson predicted that more RNs will consider the union if management doesn't follow through on its promises.

"Sometimes management is the best organizer we have," he said.