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By P.Karthikeyapra sath.
Mandatory and voluntary overtime Acuity-based staffing systems Use of temporary nurses Protections from reassignments, work
encroachment by non nurses, and mandated non nursing duties Provisions for work orientation and continuing ed ucation Whistle-blower protection Health and safety provisions, such as free hepatitis B vaccines “Just cause” language for discipline and termination Provisions for nursing and multidisciplinary practice
Collective bargaining is the “process by which
organized employees participate with their employers in decisions about their rates of pay, hour of work, and other terms and conditions, of employment.” KATHLEEN (2001)
Collective bargaining is the process through
which the representatives of the employers and employees meet at reasonable times confer in good faith about wages, hours, and other matters; and put into writing any agreements reached. Collective bargaining is the means by which professional nurses can influence hospital nursing care delivery systems and labor management relations through a united voice. Collective bargaining is often viewed as a power relationship, either adversarial or cooperative.
HISTORY IN NURSING
The following is a chronology of collective bargaining laws related to nursing in the United States: 1935: The “National Labor Relations Act (NLRA), which is sometimes called the Wagner Act, notes that hospitals are “employers.” Thus, it protects “employees of private, for-profit health care institutions. 1947: Under the amendment to the NLRA (called the TaftHartley Act), Congress accepts not-for-profit hospitals from coverage, from the right to organize, and from the right to bargain collectively. 1960: The National Labor Relations Board (NLRB) accepts proprietary hospitals from coverage by the NLRA.
1974: The NLRA amendments repeal exceptions and subject all acute care hospitals to coverage by the act. These amendments make no change in the NLRA’s authority to determine the appropriate bargaining unit in each case. 1989: The NLRB rules that eight bargaining unit’s are appropriate for each hospital. One such unit will be solely for registered nurses. The ruling is challenged by the American Hospital Association.
HISTORY IN NURSING
1974: The NLRA amendments repeal
HISTORY IN NURSING
exceptions and subject all acute care hospitals to coverage by the act. These amendments make no change in the NLRA’s authority to determine the appropriate bargaining unit in each case. 1989: The NLRB rules that eight bargaining unit’s arc appropriate for each hospital. One such unit will be solely for registered nurses. The ruling is challenged by the American Hospital Association.
HISTORY IN NURSING
1995: With the support of the American
Nurses Association (ANA), the Michigan Nurses Association argues successfully before the NLRB that nurses are not supervisors, as claimed by the Michigan Hospital Medical Center, and are therefore eligible to bargain, collectively.
characteristics of professional behavior
Specialized education and expertise Autonomy Commitment Societal responsibility for maintenance of
standards of work.
Pavalko differentiates between professionals and other workers by stating that professionals have the following:
1. A systematic body of knowledge and theory as a basis for work and expertise 2. Social ability in times of crisis; the professional is sought out by the public 3. Specified training, including transmission of ideas, symbols, and skills 4. Motivation for service to clients 5. Autonomy, self-regulation, and control by individual practitioners 6. A sense of long-term commitment 7. A need for common identity and density, with shared values and norms 8. A code of ethics
Nursing Organizations and Unions
Ø 1946: ANA becomes active. Ø 1970: One third of US work force is organized. Ø 1977: 20% of hospital workers are represented by labor unions. Ø 1980: 23% of US work force is organized. Ø 1982: ANA represents 110,000 nurses, with-the goal of controlling and protecting the nursing practice. Ø 1985: Ohio Nurses’ Association represents nurses in 29 facilities. The Michigan Nurses’ Association represents 4000 nurses in 60 bargaining units. Ø 1989: 17% of US work force is organized.
Organizations and Unions
Ø 1990: SNAs represent 1,39,000 registered nurses, with 841 bargaining units in 27 states. Other unions represent 1,02,000 RNs. 12% of US work force is organized (according-to T. Porter-O’Grady). Ø 1991: Within 3 months of the Supreme Court decision, allowing all-RN bargaining units, 20 petitions for union elections are filed by nurses in seven states. An estimated 1.12 million nurses do not belong to unions. Ø 1992: According to Joel, 3-6 million hospital employees are protected by collective bargaining.
Nursing Organizations and Unions
Ø 1977 and the 1992 percentages may relate to the measure of hospital workers. Ø The United American Nurses (UAN) replaced the Institute of Constituent Member Collective Bargaining Programs in 1999. Ø The National Labor Assembly of the UAN will elect the seven members Executive Council. The Council will be composed of a chairperson, a vice chairperson, secretary, a treasurer, and four directors at large. Ø The first Council will be members of the Executive Board of the UAN.
Organizations and Unions
Many nurses are represented by trade unions;
the ANA would rather represent them itself. Of the 2.6 million RNs in the United States, 1,90,000 are member; of the ANA. Through the ANA, the SNAs represent 2,000 nurses in collective bargaining.
Absence of procedures for reporting unsafe or poor
patient care. Quality of patient case is the number one issue. Short staffing and improper skills mix to correspond to patient acuity. Floating without orientation and training. Use of temporary personnel and unlicensed assistive personnel. Resistance of employers to accept joint decision making. Adversarial relationships between nurses and management and exploitation of nurses by
Lack of respect for employees. Lack of autonomy, that is, incursion by
management into the scope of practice. Lack of promotional opportunities. Lack of professional practice committees. Lack of staff development and continuing education opportunities. Lack of child care and eider care. Lack of Involvement
Poor differentials for shift work, education, and
experience. Low wages and limited benefits. No pension portability. Lack of employee assistance programs. Poor on-call arrangements and lack of flexible schedules. Overwork, mandatory overtime, and shift rotation. Low morale.
Performance of non nursing duties. Poor management and poor communication. No ability to takes sufficient breaks. Fair policies and practices for discipline and
dismissal. Assurance that patient classification systems have practicing nurse inputs. Fair and consistent standards, policies, and practices.
Adequate health insurance. Assurance that competence and qualification
are considered with seniority. Vacancy posting so that all nurses have an opportunity. Lack of a system to apply peer review. Lack of career ladders.
1. An organization committee is formed. It should be broad based in structure and representative of the major issues so as-to represent all prospective mem bers on all shifts and in all practice areas. Members should be well known and respected. 3. The major campaign issues are identified and discussed. 5. The organizing committee does research to obtain ex tensive knowledge of all facets of the institution, in cluding history, structure, organization, finances, ad ministration, and culture. 6. A timetable is prepared, delineating the specific or
Possible employer tactics are identified and dis
cussed, and specific strategies are developed to manage them. A system is established for keeping in constant communication with nurses. A structural plan is made, including adoption of a set of bylaws and election of officers. Recognition occurs by the employer or NLRB certifi cation. Voluntary recognition requires authorization cards signed by a majority of nurses. If the employer will not recognize the action, NLRB certification requires that at least 30% of the
An election is held in which nurse’s vote for or
against a collective bargaining unit. The NLRB sets the election date by mutual agreement. Notices posted on employee bulletin boards include the date, hours, and places of election; payroll period for voter eligibility, description of the voting unit; a sample of the ballot; and general rules for conduct of the election. With a majority of voting nurses (50% plus 1) voting for it, the NLRB certifies the petitioners as the exclusive bargaining unit. If there is no majority, the NLRB will not accept another petition for 1 year. A bargaining committee is elected by the nurses to negotiate a contract.
When all proposals have been-fully discussed
and agreed on, the contract is written. The contract is then presented to union members who vote to ratify or reject it. If ratified, it is signed by both sides. The contract is enforced through grievance and arbitration procedures. It is reviewed or amended on a regular basis.
1. Accurate definition of the problem: Does it violate the contract or the law? Is it timely? Documented? 2. Timely presentation: Follows the time limits and, steps of the grievance procedure and for notifying appropriate persons. 3. Documentation: Facts; claim adjustment desired form signed, dated, and given to appropriate persons. 4. All stops are performed with a businesslike attitude to facilitate objectivity and
Mediation is assisted negotiation. When the
negotiating parties cannot reach agreement on an issue during contract negotiations or during a labor dispute unresolved by grievance procedures, the issue is referred to a mediator trained to resolve such disputes
Metropolitan Medical Center provides a means
for you, as a regular employee who has completed the probationary appeal disciplinary actions, including dismissal, suspension, or demotion when used as a disciplinary action, that you feel are unjust or to submit a grievance for any working condition that results in inequities or other situations which have negative effect on morale.
If you are considering initiating a grievance or
appeal, you should first discuss the matter with your Department Head. You should state your case, in-writing, to your Department Head and state the adjustment desired. This should be done within 10 working days of the occurrence.
If your grievance is not settled to your
satisfaction with your Department Head you may appeal, in writing, to your Assistant Hospital Administrator within 10 working days of the response to step one.
If your grievance is not handled to your
satisfaction in step two, you may appeal, in writing, to your Division Head within 10 working days of the response to step two.
If your grievance is not handled to your
satisfaction in step three, you may request, in writing, the Assistant Vice-President of Human Resources to scheduler hearing before the Staff Grievance and Appeal Committee.
Be unequivocal (clear, consistent, acceptable);
be accepted by the people involved as the normal and proper response to the underlying circumstances presented. Have longevity; have existed for a sufficient length of time to have developed a pattern. Have mutuality; both parties regard the conduct as correct and customary in handling the situation.
With the power of unions generally declining,
goals for unions of professional nurses are best met by multipurpose organizations that can respond and adapt to the particular concerns of nurses, such as “supervisory influence, ” Generally employers raise these concerns with relation to who will represent professional nurses.
ADVANTAGES OF UNIONIZATION
Multidisciplinary and interdisciplinary collaboration Accountability Practice, based on a sound and discipline-specific
scholarly foundation (that is, knowledge, theory and inquiry) Autonomy rooted in a clear understanding of the scope and boundaries of the discipline of nursing Awareness of the sociopolitical context of practice Self-motivated professional development, Including self and peer evaluation, aimed at maintaining cur rency of practice knowledge
DISADVANTAGES OF UNIONIZATION
1. Few nurses attended union meetings regularly; although more did than do bluecollar workers. 2. Only 10.3 of respondents attended union conventions. Excuses included family responsibilities, location, expense, time off, and lack of interest. 3. Members read literature from the bargaining agent. 4. Few nurses submit bargaining demands. 5. Of respondents 45% voted in local bargaining
6. About two thirds read the bargaining agreement. 7. Few file formal grievances. Of those who did file, 65% filed for professional concerns and 37.5% for economic concerns. One-third knew Utile about the grievance procedure. They handled grievances informally first. 8. Nurses do not appear prepared to assume leadership roles in bargaining units. 9. College-educated nurses were more aggressive about work stoppages and
1. Perceived lack of responsiveness by nurse administrators in solving everyday problems experienced by nursing staff 2. Fear of change experienced by nursing staff 3. Resistance by nurses to the national trend of using unlicensed, assistive personnel to reduce operating costs 4. Perceived reduction in benefits for the nursing staff 5. Environmental and workplace health and safety concerns 6. Perceived inequities in salaries between the
Increased nursing staff turnover Increased employee-generated incidents Increased grievances filed Breakdown in communication Sudden changes in staff behavior Increased inquiries about personnel policies
and practices Changes in behavior of “problem children” Pro-union, collective bargaining, or professional organization literature, posters, or graffiti
Organization of and invitation to off-site meetings
for. 1 staff members only Formation and submission of petitions Managers’ “gut” feelings Make the nurses feel like stakeholders. This is especially important with advanced, technically trained 3 nurse specialists. Make nurses feel connected and invested in their work so they will be creative and productive. Prepare nurses to increase their role functions as members of interdisciplinary teams.
Examine the possibility of new partnership
models with nurses: shared ownership, gain sharing, bonuses, pay for performance, outcome pay, per diem contracting, caseload payment structures, benefit smorgasbords, increased autonomy of work, participation, and self-managed teams. Work can be redesigned as a result of union leadership and management partnership, with mutually formed mission, goals, and planning for the future.
Implementing the theory of human resource
management that puts trust in employees by training them to manage themselves is the best management strategy to deter collective bargaining. Nursing and health care leaders who work collaboratively with practicing clini cal nurses through decentralization and participatory management prevent collective bargaining. It has been proven time and again that people who manage their own work and who make professional decisions about their practice increase the productivity and profitability of the firm.