“Raise the subject of unionization among a group of healthcare executives today, and there is little doubt that hackles will arise. Emotions soar on interpretations of the historical evidence. That can be a problem. Historical facts, laid out, tell stories that paint either management or labor as culprit, depending on the proclivity of the author. Pro-management writers point to histories of problems with unions – how unions buck modernization and efficiency, and do on. Pro-union writers point to the exploitative history of management and its failures to do what is right for employees. History is rich with stories off failure and successes of both unions and management. But that was then. Waging historical debated does not resolve the problem that management and labor – a divisive notion in the first place – face today.” (Bruder, 1999)
Unionization of nurses has been a hot topic for many years. Recently a decision was made for a local hospital not to go union, after a few employees waged an almost ten year war fighting for what they felt was in the best interest of the nurses. In order to determine if unions would be beneficial the history and background of unions needs to be discussed.
“The development of unions in the United States goes back to colonial times when people earned their living by producing whatever craft or trade they could perform. As the production of goods continued to increase, the discrepancy between the goals of the employers and the workers widened. Management pressed for greater profits which often resulted in a decrease in worker salaries. With the industrialization of America came the battle between the profit centered employers and the powerless workers.
The American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) was born out of the desire to improve the position of skilled laborers and craftsmen by decentralizing authority and increasing employee participation in the decision-making process. Today the AFL-CIO is a large voluntary organization made up of ninety labor unions with over fourteen million members. Its function is to create a way for workers to unite and exert power in the workplace in order to gain better wages, create safer working condition, increase job security and ensure the development of a fair grievance policy. Collective bargaining is used by the employee/union representative with the employer in order to achieve those rights and privileges.” (Marple, 1996)
Now that there has been a brief discussion about the history and function of unions, lets examine what the potential benefits would be for a hospital whose nurses vote to go union. According to Bruder, “a unionized workforce, operating in a competitive environment will lead to: 1) improved quality; 2) increased productivity; 3) increased employee loyalty; 4) increased benefits; and 5) greater job stability.” (Bruder, 1999)
Now let’s look at quality and productivity as it pertains to unionized nurses. According to Bruder management is concerned that unions will drag their feet, impend progress, stall efficiency and protect obsolete jobs. This is what has happened in the past but labor unions have now realized that over the years, their employees retain job stability by being prepared to move along with modern technology. (Bruder, 1999)
This is an issue that healthcare has been familiar with ever since it started, especially nursing, due to the ever surfacing research through evidence based practice as well as innovations in technology. Labor unions recognize that ensuring quality of the product and service (nurses and healthcare); that the consumers come to trust the product and service more. (Bruder, 1999)
Now let’s discuss loyalty. Typically, or should it be stated, more often than not, it is the employees working in the “trenches” every day that seem to receive the awards or recognition for their length of service, not upper management ant the corporate executives. Unions would only serve to help strengthen this by giving the “lifers” a stronger voice and a more fair work environment. (Bruder, 1999) It has been the experience of this nursing student as well as Mr. Bruder that the length of stay for a member of upper management is relatively short, three to five years. At the end of that time period, every employee is on pins and needles for fear that the new administrator will come in and “clean house” so to speak. The stability that a union offers would allow for the employee to concentrate on their jobs and be more productive when that happens, and would thus increase loyalty.
Let’s now examine benefits. Unions – contrary to the popular notion by people who are supporters of non-union – are not out to make their employees wealthy. Income is a secondary benefit. “Money is part of the issue, but professional unions, nursing unions in particular, have far greater concerns than negotiating higher wages – as important as that might be.” (Bruder, 1999)
Unions are seeking a reduction for their employees in “job-related stress, long working hours, and increasing demands from a management force that too often does not understand the work to be done in the face of ever-sicker patient populations. Most nurses want control over their working environment in a way that allows them to provide better care with less personal stress; they want a voice.” (Marple, 1996)
Staffing concerns is another benefit that nursing unions can help improve. “Nurse-to-patient ratios can depend on a litany of variables, including the health of the patients, the nurses’ skills and the working environment. In California, the first state to pass laws setting nurse-to-patient ratios, the numbers are determined more by political negotiations among nurses, insurers, and hospitals than by scientific evidence. In October 1999, California established minimum nurse-to-patient rations for acute-care, acute psychiatric and specialty hospitals. The rations range from one nurse per patient for trauma patients in the emergency room to one nurse per six patients for in psychiatric wards. For general patient care, the ratio is one to four. The ratios apply at all times, including during nurses’ meals and breaks, and offer no leeway in high-volume periods such as flu season.” (Roberson, 2008) The California nurse union was an integral part of the lobbying process to get this bill passed.
Another article that was researched comes to us from Michigan, and it titled Cutting-edge education: breaking the silence about nursing unions. This article discusses the ground breaking educational class offered at Michigan State University and sponsored by the Michigan Nurses Association (MNA). The class was offered to baccalaureate and degree-completion nursing students and was based on the premise of collective bargaining. (Selanders, 1999)
The class was taught to senior nursing students and the objectives were to “provide students with facts about collective bargaining; create a professional dialogue among students, faculty, and presenters; stimulate thoughtful decision making about collective bargaining as an alternative to powerlessness; and examine pre-existing stereotypes about unions held by students and faculty.” (Selanders, 1999) The premise of the course was that the students were required to decide whether to organize into a collective bargaining unit and to also decide whether to select a trade or professional union as their representative, if they choose to organize.
“At first, students believed that belonging to a professional union was a ‘blue collar mentality,’ that striking w as immoral because it constituted abandonment of patients and that strikes always involve violence and property damage. However, students discovered that strikes by MNA staff nurses are a rarity and that the employer is given ten days notice prior to a strike so that the employer can discharge appropriate patients or arrange for staffing by managers. Students also learned about informational picketing and the role of community support in a strike. Finally, the absence of violence and property damage in strikes involving nurses was discussed, particularly in terms of ethical behavior or professionalism.” (Selanders, 1999)
At the conclusion of the class, the students did vote to organize with MNA and both sides (baccalaureate and degree-completing students) chose the professional union as their representation. “The greatest outcome of the collective bargaining class was the realization that powerlessness in an insidious and demoralizing force in the workplace – a force to be actively battled.” (Selanders, 1999)
From the information presented in this article, it is pretty clear that nursing unions are a major benefit to the healthcare workforce. The unions represent the nurses and make sure that they are treated fairly and have the appropriate nurse-to-patient ratio so that the nurses can properly care for their patients. It is the opinion of this nursing student that if ever given a chance to vote for or against a union, this student is going to vote pro-union.
Author: Jason Hawkins RN, BSN, MSN.
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