Employers in health care have seen a significant increase in union efforts to organize nurses during the past few years. The national rate of unionization among nurses now exceeds 23 percent, whereas in 1998 it was less than 17 percent. Nationwide, unionization in health care fields is 14 percent.
Nurses are a desirable source of new members for unions. On average, nurses make more money than many other non-exempt employees. In addition, they work in a growth industry, and their jobs cannot be easily outsourced.
Message Shift
Traditionally, nurses have had little interest in joining unions. They typically view themselves as professionals, in sharp contrast to the blue-collar workers usually organized by unions.
In order to make the necessary inroads with nursing professionals, unions have refined their messages and agenda. The shift in message and tactics has resulted in more union campaigns, more union campaign victories, and higher union dues across the board.
The retooled message focuses on an issue of the utmost importance to nurses: Patient care. Health care unions are now playing on fears the recent changes in the health care industry (including privatization of hospitals) have led to a general decline in patient care.
Unions are promising nurses a louder voice in patient care, as in the recent move by the Service Employees International Union (SEIU) to launch SEIU Healthcare, a new national health care union with more than 1 million members.
Retooled Union Agendas
Health care unions, including SEIU Healthcare, have retooled their agendas to include four major demands:
1. establishment of “minimum staffing standards limiting how many patients employees must care for in a particular area on a particular shift”;
2. creation of “labor-management committees through which employees make joint decisions with administrators about staffing guidelines”;
3. restricting “mandatory overtime to protect employees and ensure the highest quality patient care”; and
4. creation of “guidelines for floating and other practices to ensure that employees are able to provide the best possible care to their patients, and to do so under conditions for which they were properly trained.”
This is in addition to the more traditional issues negotiated during collective bargaining, such as wages and benefits.
Unions are also distributing at least one study suggesting patient care is better in union settings. The study, by Jean Ann Seago, Ph.D, RN, and Michael Ash, Ph.D, focuses on hospitals in California, where 35 percent of nurses are now unionized. They found California hospitals with nursing unions have a lower risk-adjusted mortality rate for patients with heart attacks. The authors claim “there is a positive relationship between patient outcomes and RN unions”–a dangerously broad conclusion.
Valid Concerns
The message and agenda of health care unions such as SEIU Healthcare appear to be resonating with nurse professionals, who are now considering unions and collective bargaining in record numbers. In October 2007, SEIU Healthcare alone had organizing victories in Nevada, New Hampshire, Tennessee, Virginia, and Wisconsin.
As the nurse unionization movement continues to gain momentum, health care employers of all sizes should recognize nurses are organizing not only to protect themselves but also to gain a broader voice in patient care decisions.
Health care providers whose nurses believe they are unable to participate effectively in caring for their patients must recognize there is a host of unions seeking to organize nurses by promising to give them this very opportunity–and they must change their way of doing business accordingly.
Todd D. Wozniak ([email protected]), of Greenberg Traurig, LLP, is a labor/employment and health care law attorney.
