Professionals or "workers"

Nurses Union

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  • Specializes in Med/Surg, Gyn, Pospartum & Psych.

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Specializes in Critical Care, Education.
I'm originally from California (a state with nursing unions) and have been living and working in Texas (an at-will employment state) for the past 7 years.

In Texas, a nurse's employment can be terminated for any reason that the employer sees fit under at-will employment. I have seen many nurses down here get canned for silly reasons. Raises are not guaranteed in nonunion facilities. One new grad can start at $22 hourly, and another new grad can be started at closer to $30 hourly if (s)he has inside connections. A union would allow everyone to be started at the same pay rate.

Sorry, but bedside nursing is not yet a profession in my opinion. Rather, it is an emerging profession that still needs protections. Most other professionals do not punch time clocks, wear uniforms, require close supervision, receive hourly wages, or lack the autonomy that characterizes bedside nursing. The bedside nurse has plenty of accountability without the authority. Rant over.....

While I can understand Commuter's point of view about 'becoming a profession, I want to point out that paying different salaries to similarly qualified individuals who are hired into the same job is a violation of FEDERAL law, and certainly not allowed. That's why starting salaries are controlled by HR rather than by hiring managers, who may be more focused on their own needs rather than those of the organization. Employers in TX are not exempt from 'wrongful termination' lawsuits, so the threat of being fired "for any reason" is not quite accurate either.

My primary disagreement with organized labor is the insistence on job tenure as the end-all & be-all. Nurses with higher levels of experience are always given preference, with very little attention to the quality or quantity of their work. Conversely, newer nurses are artificially restricted in terms of career growth, no matter how expert or qualified they become. But then, I don't believe in academic tenure either.

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Physician assistants require a pre-medical undergraduate education and a master's degree to enter practice at this point.

*** Better tell the associates degree PA programs out there.

Physician Assistant Program

City Colleges of Chicago - Physician Assistant Associate in Applied Science

General Information - Primary Care Associate Program - Stanford University School of Medicine

Physician Assistant Program | SJVC

I

'll give you respiratory therapists, but they don't seem to be shouting from the rooftops that they are professionals like we do in the nursing world.

*** I don't think they have the self esteem problem that nursing is afflicted with.

Nurses like to talk the talk, but until we walk the walk and stop only requiring what is essentially a vocational degree, we will not be recognized as professionals like we desire.

*** Don't count me among that "we".

monkeybug

716 Posts

Specializes in Public Health, L&D, NICU.
Employers in TX are not exempt from 'wrongful termination' lawsuits, so the threat of being fired "for any reason" is not quite accurate either.

My primary disagreement with organized labor is the insistence on job tenure as the end-all & be-all. Nurses with higher levels of experience are always given preference, with very little attention to the quality or quantity of their work. Conversely, newer nurses are artificially restricted in terms of career growth, no matter how expert or qualified they become. But then, I don't believe in academic tenure either.

I work in a right-to-work state. Yes, we have wrongful termination laws. But in a right to work state, this is easily gotten around. Nurse assaulted by physician in front of a roomful of witnesses and complains about it? Nurse has a few weeks of grace before they find where she forgot to check a box on a flowsheet, and she is terminated for improper documentation. But, honestly, they didn't have to give her a reason, because either party has a right to terminate the relationship at any time. But they will give a reason, just to show everyone that it is not, obviously, as retribution for raising a stink about some low life putting his hands on her. True story. And I know you are new, and may think, well, she didn't chart something! She should be fired. But with all the myriad forms that are required now, and with all the double charting, it's very easy for even the best nurse to miss a box here or there. And, really, everyone, including the piece of crap MD, knew she was fired for not being a good little minion and just taking it.

As for the preference given to more experienced nurses, in a right to work state you certainly don't have that. Nope, no poor patients subjected to nurses with 20 and 30 years of experience! All that knowledge and spidey sense that comes with years of experience is expensive! They cost way too much, much better for the hospital to hire some fresh young thing who doesn't know which end of the Foley to insert. But that fresh young thing will take what management dishes, and do it for $10 an hour less. And if the patient goes down the tubes because the young one didn't recognize it, or was too scared to call a doctor at 3am, well, thems the breaks. I know nurses who were terminated within weeks of their retirement date. Because the hospital can do that in a right to work state. Voila! No nurse at topped-out salary, no providing health insurance for an older person, and the old nurse is oh so replaceable since there are 4 nursing schools pumping out new grads as fast as they can within a 60 mile radius.

I have never been a member of a union, never paid union dues, but I have benefitted from their efforts in nurse-to-patient ratios, and mandatory breaks. I've also done it the other way, and that way is like living on the edge of a cliff. And the older, wiser, and more expensive you become, the more precarious your position is. Easy to disparage preference for seniority when you are new, but one day you'll be the older, experienced, expensive nurse, and that might change your perspective.

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I should also mention that the US is the only country who still allows RNs to enter practise with a Diploma.

*** Absolutly not the case. All of those countries you mentioned have plenty of diploma RNs practising.

E

verywhere else (Australia, Canada, the UK) a Bachelor's Degree has become mandatory for all new RNs.

***It's worth remembering that some of those countries have 3 year BSN programs that differ little from american ADN programs. I am a citizen of New Zealand (dual US/NZ) and hold a NZ RN license and used to hold a Queensland RN license and have worked as an RN in those countries.

W

hile many people argue against a BSN, the degree is one measure that allows nursing to be regarded as a profession. As a result, the working conditions for nurses are slightly better in these nations.

*** Maybe but there are a lot of other things to consider. The differences in the national health care offered in those countries vs the for profit model used here account for some of the difference. My personal experience is that nurses are NOT treated better, though I can only speak from personal experience for Australia and NZ.

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
This is news to me. Everywhere I've worked PAs are midlevel providers just like NPs.

*** Yes they are, even those with associates degree.

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

My primary disagreement with organized labor is the insistence on job tenure as the end-all & be-all. Nurses with higher levels of experience are always given preference, with very little attention to the quality or quantity of their work.

*** That is absolutly not the case for the union hospital where I work. Maybe not all unions are the same.

SleeepyRN

1,076 Posts

The OP used some pretty inflammatory language against unions. That is not indicative of someone who is confused or is welcoming of dissenting opinions or advice. That is indicative of someone who lacks manners.
Im thinking Im not understanding OP's post then. I admit I was wrong. Im pleading ignorance. I guess I dont get it, so Ill leave the topic alone. In my defense on another note, I did point out that I realized I didnt quote what I was referring to and corrected that. Anyway, like I said, I apparently misunderstood the thread from the beginning. Sorry

alotusforyou

30 Posts

It shouldn't matter if you are a professional or not, if you work under management of any kind or as an employee, a union is probably always a good idea.

It doesn't matter how knowlegable, educated or skilled you are, if you do not own the means of production or have extensive capital, you have little power without a collective voice.

Some professionals, like physicans, may have enough power on their own because many have specific skill sets that take tons of money and time to aquire. They are not easily replaceable. But alas, nurses are easy to replace these days.

I'm sure the powers that be are very happy to know that some think that unions are demeaning and only for the weak. That serves their agenda well, especially when it comes to exploitation.

sapphire18

1,082 Posts

Specializes in ICU.

I have never heard of a "profession" as against higher education as nurses. It makes a lot of sense that someone with a 2-year degree can write orders, examine patients and document progress notes, H&Ps, and discharge summaries of critically ill patients while the 5-year degree-prepared nurse is following/carrying out those orders; basically working BELOW someone with less than half the education than they have. All I can say is...SMH.

kissafish4

30 Posts

I've worked in Alaska which is unionized and now I live in Texas which is not. There is a HUGE difference in the quality of work conditions and compensation directly related to the nursing union. Not all professions need a union but nursing is certainly one that can benefit from it. Keeping nurse patient ratios to a manageable level is just one benefit not just for the nurse but also for the safety of patients we care for. The nursing union in Alaska assisted with lay offs, retraining if you were unable to perform your job anymore, negotiations for benefits, etc. It was a lot easier to actually be at the bedside nursing like we were trained to do because lower patient ratios and extra support staff etc. If someone feels it "demeans" the profession I don't really care because I know it keeps my patients safer and me at their bedside. Which is what I went to nursing school to do.

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I have never heard of a "profession" as against higher education as nurses. It makes a lot of sense that someone with a 2-year degree can write orders, examine patients and document progress notes, H&Ps, and discharge summaries of critically ill patients while the 5-year degree-prepared nurse is following/carrying out those orders; basically working BELOW someone with less than half the education than they have. All I can say is...SMH.

*** Seems perfecly normal and right to me. I don't give a darn for the degree. To me what matters is what you know, not how you came to know it. Before I got my BSN I used to regularly precept nurse residents who had MSNs. Sure they had 6 years of "education" vs my 2 years (actually 9 months but it's a two year degree). They were still wet behind the ears know nothing brand new grads who needed to learn basic nursing skills from me. Does that seem wrong to you? Would it be better if the brand new graduate of a direct entry MSN program was supposed to precept the ADN RN with 10+ years of ICU experience? After all the new grad has 6 years of "education" (never mind that the first 4 years could have been in music) vs the experienced nurses 2 years?

The associates degree PA and the BSN RN both spent about the same amount of time in school learning their trades.

allnurses Guide

nursel56

7,078 Posts

Specializes in Peds/outpatient FP,derm,allergy/private duty.
I have never heard of a "profession" as against higher education as nurses. It makes a lot of sense that someone with a 2-year degree can write orders, examine patients and document progress notes, H&Ps, and discharge summaries of critically ill patients while the 5-year degree-prepared nurse is following/carrying out those orders; basically working BELOW someone with less than half the education than they have. All I can say is...SMH.

The issue is that for the most part, hospitals, state governments and the general public have not felt any type of urgency in the last 47 years to either separate RNs by scope, change the licensing exam or sound the alarm that the public is endangered being cared for by a mostly ADN workforce. That's not an insignificant factor.

The major nurse lobbying groups have successfully framed the argument as either for or against higher education in general. There are many avenues that nurses can and do take to educate themselves every day, both informal (personal initiative and professionalism) and formal, like certifications. Once you are out the door with your degree, you're fighting it's obsolescence. Some nurses, regardless of degree, are lifelong learners and some put the degree on the shelf and do as little as possible to grow beyond that. Additionally, the further education a practicing RN may pursue is usually focused on her practice area, while the gen ed and other courses in a typical BSN course have little effect on their current practice, especially after they've been out of school for a while and know what they need to know more about.

as to the topic: I used to be against unions. Now I am 100% for them, despite some misgivings. Wages and benefits have deteriorated massively since healthcare became primarily a profit-driven corporate machine. In short, they can't be trusted.

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