Patricia has a BSChE. She's an experienced registered nurse who has worked in various acute care areas as well as in legal nurse consulting.
A Nurse's Day
''Maria, you don't look so hot. Have you had a break yet today?''
''Just enough time to wolf down a banana, Suzy. I'm exhausted. They made me stay over last night to pull a double shift, so I did both days and afternoons and didn't get home 'til after midnight. This mandatory overtime is killing me.''
''Yeah, I know what you mean. Last week, the clinical manager told us we'd have to punch out and keep on charting till we're done if we can't finish our charts on the shift, so we won't even be paid for it. Now that really makes me mad!''
Conversations like these can be all too common in the healthcare industry, and they're also part of why nurses need labor unions.
Why Nurses Need Labor Unions
During the past years, nursing has often been considered a ''calling.'' The image of the dedicated nurse in a white cap and starched dress at the patient's bedside late at night is still in the minds of many. But during recent decades, the management of healthcare facilities has been taken over by large corporations and consulting firms. These managers, with their business degrees, lack of medical training, and detachment from the reality of the healthcare environment, as well as profit motives, have redesigned the care environment with their own goals in mind. Hospitals and their staffs have been restructured, downsized - sometimes brutally. As a result, much of the trust that nurses once had in their administrative leadership has been lost.
As stated in an executive summary in The National Academies Press of the report, ''To Err is Human: Building a Safer Health System'' from the Institute of Medicine, ''This loss of trust stems in part from a perception that initiatives in patient care and nursing work redesign have emphasized efficiency over patient safety.'' And, since data on poor patient outcomes and deaths in hospitals during recent decades correlates with this loss of trust, it is clear that nurses need a strong voice to advocate for their patients, and for themselves. This voice can come from the use of collective bargaining or the creation of labor unions for nurses. Collective bargaining is the negotiation between labor and management to establish wages, working conditions, hours, and other relevant issues.
Benefits of a Nursing Union
Several benefits of union membership for nurses are outlined in an article on the Health Research Funding website, May 15, 2015. These are:
The union provides a voice against the health care provider's management. This is very relevant today as nearly all healthcare facilities are now run by people with business training who have never cared for a sick person in their lives.
Management is often interested in the facility's budget and may try to staff the units by changing shift hours, by using mandatory overtime, or by using nurses from outside agencies, whom they may pay more than regular staff. They may cut the basic staffing matrices that designate how many patients one nurse may care for. Without a union, there isn't much that the nurses can do. With a union, they can document these issues and file Unfair Labor Practices and grievances, and they can report the issues to the National Labor Relations Board, or NLRB, which can then investigate the matter and can rule against the management. It can even collect fines. Fines mean money spent, which quickly gets the attention of a profit-driven management.
Next, the union can clarify the disinformation that managements often put out into community media sources during negotiations. Unions have a spokesperson who can deal with news media during a time of contract negotiations or during a strike. This is an unfortunate situation that really does occur.
As the Health Research Funding article points out, a healthcare provider's president made a very misleading comment during a strike at Quincy Medical Center in Boston. He said, ''In today's economy, nurses who are sitting by empty beds making $52 per hour is unfeasible.'' The reality of modern hospitals is that patients are often waiting in the ER for a bed because there are simply not enough of them to accommodate everyone who needs admission. In addition, it is highly unlikely that any nurse has ever made $52 an hour unless she is working on a holiday or for overtime. But clearly, the comment was designed to create a negative image of the nurses in the dispute.
Third, a union puts the focus on care instead of profit. Data that has been collected does show that hospitals with unions have better patient outcomes because nurses have fought for, and won, a safe patient care work environment.
One study (Seago & Ash, 2002) investigated the outcome of patients with acute myocardial infarction, or AMI, who were treated at union hospitals versus non-union hospitals. The results state, ''The significant finding in this study is that hospitals in California with RN unions have 5.7% lower mortality rates for AMI after accounting for patient age, gender, type of MI, chronic disease, and several organizational characteristics.''
Finally, unions create more job security for nurses. This is true because, for one thing, a union gives nurses a written contract, as well as an additional chain of command for dealing with toxic managers who show favoritism or who harass or bully them. When that happens, they have someone to go to who is obligated to be on their side.
Again, the healthcare work environment has changed in recent years due to the increase in corporate, profit-driven facility leadership. This type of leadership has created a difficult work environment for nurses, in which methods such as mandatory overtime and long shifts are often used to save money without much consideration for the negative effects this may have on nurses and on patient care. As a result, nurses need a voice to represent the interests of their patients and of themselves. Collective bargaining through the formation of a labor union can provide that voice.
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