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Latest News - September 2011

September 4, 2011
Union organizing shifts to white-collar jobs, especially in hospitals
Source: The Kansas City Star
By: Diane Stafford

A blue-collar pipe fitter isn’t the classic illustration of union organizing anymore. It’s a health care professional in comfortable white shoes.

Look no further than the registered nursing profession to see that much of today’s collective bargaining spark is being lit inside hospital walls.

On this Labor Day — a time when America nods to the role of organized labor in advocating for working conditions — the focus shines on the relatively small but fast-growing unionizing effort among white-collar workers.

And that focus zeroes in on registered nurses. Around the country, RNs have held and won union elections, including at some hospitals in the Kansas City area.

Primarily pushing back against having to care for more, sicker patients per nurse, “there’s an organizing wave among these professionals who were not traditionally unionized,” said Liz Jacobs, communications specialist for National Nurses United, the largest organization representing RNs.

Many hospital RNs are coping with the kind of staffing cuts that have affected American workers across the board. Some nurses have left acute care because of it.

Other RNs — again, like workers in other industries — accept the “new normal.” They adapt to new working conditions to hold on to their jobs.

Into this new normal, nurse organizers come armed with national studies that show fewer patient deaths and fewer infections when each RN has fewer patients to care for.

“There’s a steady body of literature that indicates nurse staffing is essential for quality,” said Joanne Spetz, professor at the Institute for Health Policy Studies at the University of California-San Francisco. “It’s not so much that the nurse-to-patient staffing ratio has grown. It’s that the hospital patients are what’s called ‘sicker and quicker’ — they need more attention.”

Hospital spokespeople agree but say that high-quality care doesn’t require unionization.

“Patient safety is a high priority for us, and we do well with patient safety regardless whether or not we have a union,” said Susan Kaufmann, vice president of public relations for HCA Midwest Health System, which has some hospitals with organized RNs and some without.

Julie Perry, an RN in Kansas City, said her experience shows that “when there aren’t enough nurses, there are poorer outcomes” — for patients as well as the nurses themselves.

“And it results in voluntary nurse turnover, which means that monthly you have nurses leaving and nurses coming in, and that’s not good,” Perry said.

In hospitals, as in many industries, such worker complaints typically are muted. So it’s unusual when labor market analysts point to the nursing profession as the sector where workers are making noise.

Only about 10 percent of registered nurses now are covered by collective bargaining, but when there’s a union election, “more than eight out of 10 times we’re successful in our organizing vote,” Jacobs said.

Most RN organizing is being done in acute-care hospitals — not doctors’ offices or other health care venues — and results are a patchwork of responses. The American Hospital Association’s position is that it “respects the right of individual hospitals and health care systems to determine the appropriate hospital-employee relationship for their organization and community.”

According to the U.S. Bureau of Labor Statistics, there are about 1.6 million hospital RNs. National Nurses United says about 30 percent of hospital RNs are organized, and it represents about three-fourths of them.

That growth is coming despite lack of interest in or outright antipathy for unions among many workers. Fifty-five percent of Americans polled last week by Gallup think labor unions will become weaker in the future than they are today.

And The Harris Poll said last week that while 65 percent of Americans credit labor unions with improving working conditions, a majority nonetheless said they dislike unions’ political involvement and feel like unions stifle change and individual initiative.

Indeed, some organizing efforts aren’t successful, and some nurses actively oppose organizing efforts.

Last August, for example, a Research Medical Center nurse filed a National Labor Relations Board complaint, charging that workers who opposed a union campaign weren’t getting equal access to share information.

A month later, nurses at Research voted to organize, as had nurses at Menorah Medical Center.

At Lee’s Summit Medical Center, though, nurses that had been organized since 2000 voted to oust the union in 2009, and a subsequent effort to organize was withdrawn this year.

“It’s not like how I grew up in the union,” said Bob Hemenway, a union activist and retired pipe fitter who followed many relatives and friends into the trade. “Most nurses don’t have those union family ties. When they vote nowadays, they’re looking at the current working conditions, not a union heritage.”

At the University of Missouri-Kansas City’s Institute for Labor Studies, director Judy Ancel said unionizing usually is “a long and arduous process, and it’s difficult to keep morale up with all the barriers employers can throw against it.”

She sees a big difference in unionizing success rates among RNs based on the nature of individual hospital management.

“There’s the old saying that bad managers get unions,” Ancel said. “The desire to unionize is directly related to working conditions.”

Labor advocates say the health care industry is well-trained and well-organized to keep unions out. And many employment law attorneys specialize in union avoidance.

Shelly Freeman, a management-side employment law attorney and consultant at HROI in Kansas City, acknowledged that RN organizing is a trend — one based on working conditions, uncertainty about health care reform, and hospital budgets squeezed by reimbursement cutbacks from the government.

“These are more complex problems than unionization can solve,” Freeman said, “but there’s no question that nurses in some areas of the country have done an effective job. Because of the economic circumstances, the sector is vulnerable.”

The advice Freeman gives to employers is to listen to their employees.

“Organizations that don’t get unions are good at communicating directly with their employees and not through intermediaries,” she said.

Communication or not, union organizers are making small inroads among professionals because of “wake-up calls to the workforce that they were losing tangible things that had taken decades to obtain,” Ancel said.

Registered nurses and unions
•About 170,000 RNs, or about 10 percent of RNs in acute-care hospitals, are represented by unions.

•National Nurses United has organized 11,000 RNs since 2009.

•The health care sector has the fastest growth rate in the organized labor movement.

Sources: National Nurses United and AFL-CIO



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